![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 3 to 27 of 55. Go back in thread:
Posted by fachad on April 4, 2002, at 20:37:04
In reply to ANYONE'S ANXIETY HELPED BY A STIMULANT?, posted by jaby on April 4, 2002, at 18:55:52
Well, it's a bit of a stretch, but here goes. No one is allowed to say that this is hokey!
I *feel better* in many ways when I take Sudafed. I think the primary mechanism of action for me is just breathing easier and breathing more.
I have been chronically congested all my life and I know that when I am stuffed up, I don't take in as much air. That makes me groggy and disphoric.
When you're breathing easier you are also expelling more CO2. So the combination of more oxygen taken in and more CO2 expelled just makes you feel better.
True stimulants like Dexedrine tend to increase anxiety, including the physical components of anxiety like heart rate and blood pressure.
> I know this doesn't seem like common sense, but I have anxiety/depression (been through tons of meds) and have been told by a doc to take sudafed daily to combat a sinus infection. I am getting a serious AD (stimulant) effect (as I know it can)from it and notice that my anxiety is better. I am a bit on edge, but it is not the hopeless, dreadful anxiety that I usually experience. Does anyone's anxiety benefit from a true stimulant. All replies are much appreciated.
Posted by IsoM on April 5, 2002, at 1:58:24
In reply to ANYONE'S ANXIETY HELPED BY A STIMULANT?, posted by jaby on April 4, 2002, at 18:55:52
Quite a few people's depression and/or anxiety improves on a stimulant. Mine does. I also feel much better when I've taken a decongestant like pseudoephedrine. Unlike fachad, it has nothing to do with being able to breathe easier. Stimulants make me feel alive & focused. (I have ADHD & narcolepsy.)
Posted by dennison on April 7, 2002, at 5:17:06
In reply to ANYONE'S ANXIETY HELPED BY A STIMULANT?, posted by jaby on April 4, 2002, at 18:55:52
Hi --Yes dexedrine I found helped anxiety,it was very noticeable. Ritalin and cylert and especially provigil on the otherhand caused anxiety.
Posted by paxvox2000 on April 8, 2002, at 18:18:57
In reply to Re: ANYONE'S ANXIETY HELPED BY A STIMULANT?, posted by dennison on April 7, 2002, at 5:17:06
Yeah, but try convincing your Pdoc to scribe you some! My doc has me on the Wellbutrin, which in theroy works like a CNS stimulant. He said at one point I had ADHD, but I guess I'm too old for the "kid's stuff" (i.e. amphets). Go figure.
PAX
Posted by sid on April 9, 2002, at 11:24:25
In reply to Re: ANYONE'S ANXIETY HELPED BY A STIMULANT? » jaby, posted by IsoM on April 5, 2002, at 1:58:24
Hi IsoM,
what stimulant do you use?
I don't feel depressed anymore, but I feel soooo tired all the time that I need to do something about it. I'm apathetic, and nomatter how much I tell myself I should get up, get out and do something (Macy Gray song!), I'm stuck to the sofa.
My doc talked about perhaps adding a stimulant to the Effexor XR I am currently taking, but since I know nothing about stimulants, I'm trying to figure out what I can expect.
Thanks in advance...- sid
Posted by IsoM on April 9, 2002, at 16:35:09
In reply to Re: ANYONE'S ANXIETY HELPED BY A STIMULANT? » IsoM, posted by sid on April 9, 2002, at 11:24:25
Sid, I take adrafinil (you know - one of its metabolites is Provigil, modafinil) but I don't have any at this time as the online company ran out of supplies (it must be popular) so I ordered from another online site. Right now, I'm using Dexedrine again but I feel the mood difference. I'm being touched by my depression some as I'm getting a "don't give a damn" attitude. Not apathetic but irritable with stupidity & other human frailities. Got fed up with my supervisor (justly so mind you) & gave my two weeks notice. Now she's all over, trying to make up, & told me I could change my mind. I'll see. Maybe my depression is talking a bit, but I would still be upset even with the adrafinil. With it though, I might be able to handle the situation better. I've got to remember that when I'm working, the union covers the cost of my meds & dental.
Both Dexedrine & Provigil would help with the apathy but I like the even-level effects on adrafinil/modafinil. I don't wake up apathetic & groggy with it as I do with other stims. The benefits from other stims (for me, at least) just lasts as long as it's in my system. The dose wears off - the effects wear off. Adrafinil seems to give long-lasting effects that don't go away till a few days after stopping it.
Posted by Michael K. Junk on April 9, 2002, at 18:55:40
In reply to Re: ANYONE'S ANXIETY HELPED BY A STIMULANT? » IsoM, posted by sid on April 9, 2002, at 11:24:25
This is a good question, with a simple answer: OF COURSE IT DOES! Stimulants are amphetamines. People don't cook their own and risk jail because it makes them feel bad - they cook their own and risk jail because it makes them feel GOOD! Let's be honest - not to "scare" anybody - but all of these amphetamines are nothing but speed. It makes you feel good. Sure it does - no denying it. It "stimulates" activity in your brain and can cause an almost "euphoric" feel - while it lasts. But then, it takes more and more and more for the same feelings. I took Adderall because of "Adult ADD" and immdiately felt great - imagine that! I took uppers and I felt better! I thought, "Hey! This was my problem! Adult ADD!." No, my feeling better was caused by my taking speed by prescription. Of course I could concentrate better! Of course I could get up and around! Of course I wasn't as depressed! Of course I could accomplish things and "carry through" with things I couldn't before! Of course the good feelings made me feel less anxious! As it "wore off" daily, I felt a little down and irritible in the evening. If children take it, as it wears of, they sometimes get a tad rambunctious. That's called -- as bad as some people had to admit it - coming down off the HIGH.
It's mimportant to remember that "addiction by prescription" (also the title of a good book) means that the worst drug problems can start in the doctor's office, not on the street corner. Read Betty Ford's story, or Tammy Faye Bakker and how she coped with her husband's ministry falling apart, Stevie Nicks of Fleetwood Mac.
Keep in mind ADD is a "disorder" barely recognized in Europe as hard as the drug companies are trying to push the idea there.
There IS a way out though:
http://www.amphetamines.com/I only come here to look for things to help me escape the addictions of uppers AND downers! (Adderall and Klonopin -- and Zoloft for good measure.) Remember these chemicals are all sloshing around in our brains and doctors simply do NOT know all of the ramifications. However, those who have been there and their brains have been the receptors of these chemicals over a period of time, have plenty of stories to tell -- all over the Internet. If benzos are your problem - make a stop at:
http://www.benzo.org.uk/
http://www.geocities.com/benzodebate/There are times for drugs, but these drugs are being handed out like candy corn to adults and children alike. I hope you don't become defensive with replies like, "I feel better than I have in my whole life," because - I am not surprised and could not possibly disagree. But, it is JUST as important you understand there are consequences long-term. I know.
Michael
Posted by sid on April 9, 2002, at 20:09:22
In reply to STIMULANTS? » sid, posted by IsoM on April 9, 2002, at 16:35:09
Thanks... I'm already groggy in the morning, so I do want to avoid that as much as possible.
I've basically reached a stage where I've toughed out the Effexor XR long enough that I realize this problem is not going away and I need something else. Effexor XR is great for my dysthymia, but physically, I always feel like I just ran a marathon and need to rest for a week. Hard to do my job and other things I like to do...
Thanks again - can't wait to see what my doc suggests.- sid
Posted by IsoM on April 9, 2002, at 22:43:26
In reply to Re: STIMULANTS? » IsoM, posted by sid on April 9, 2002, at 20:09:22
Sid, I reread my post to you & realised I didn't make something clear. When I say I wake up groggy, it's not a result of the stims - it's me naturally & taking something like Dexedrine doesn't counter it as when I wake up there's no Dexedrine left in my system, of course. But when I wake up from regular use of adrafinil, I don't wake up groggy. It seems to make my brain normal & I wake up like a normal person - groggy for about 5 minutes then properly awake. Hope I'm clear now.
Posted by sid on April 10, 2002, at 7:11:31
In reply to Didn't Make Myself Clear » sid, posted by IsoM on April 9, 2002, at 22:43:26
Posted by katekite on April 13, 2002, at 16:45:56
In reply to Re: ANYONE'S ANXIETY HELPED BY A STIMULANT?, posted by Michael K. Junk on April 9, 2002, at 18:55:40
Most people with ADD find stimulants really decrease their anxiety.
I wouldn't know the meaning of the word euphoria, personally. And ritalin has really helped my feeling frantic and anxious all the time, frustrated with life and that life is harder for me than others. I had vague symptoms. With ritalin I feel relaxed physically and think slowly. I can tell when its time for the next dose when my brain starts to think several things at once, or only parts of thoughts. Jumping around.
I have to be honest though, I've only been on it for a few days so I can't know if the effect will wear off. Diagnosed at the age of thirty. But my brother was diagnosed at 4. 41 years ago. I do not doubt the diagnosis whatsoever. I simply wasn't physically hyper. Instead I was tense. I say 'was' because ritalin has helped more in two days than any other drug I have ever taken. I say this and at the time say I do not feel happy. Rather I feel hopeful and a little disturbed over all the years I had to feel tense.
To me ritalin feels almost identical to valium, except with the amount of valium I would have to take to be able to feel this relaxed I would also feel stupid or really sleepy.
Certainly that is not the average response to speed. That is the ADD response.
I have to say the reason it took me 10 years to try ritalin was because I myself really thought it was probably a pretty hokey diagnosis. That its so overdiagnosed, that yeah my brother definitely had it but that I didn't have every classic symptom and I did well in school so therefore it was a remote possibility.
I am absolutely convinced now that it is underdiagnosed. If it took 25 years for me to get diagnosed there are others with milder cases who will never get diagnosed. Maybe its the modern diet, maybe its smog, maybe its drinking coffee in pregnancy, I have no idea. But it is a real thing.
Sorry to rant. But I think everyone on any psychiatric medication deserves to have a real full evaluation. To get diagnosed properly to begin with. Try a continuous performance test. If you are going to be treated for life for anxiety issues or for depression its well worth the money to rule out ADD at the beginning.
kate
Posted by oona on April 13, 2002, at 22:18:22
In reply to ADD diagnosis 1 week ago, completely calm now » Michael K. Junk, posted by katekite on April 13, 2002, at 16:45:56
Exactly how do you get diagnosed with ADD?
My son may have it and he is 28?
He has had a lot of drug problems but I always thought he was ADD when that first came to light. It was after he was already grown. I remember him as a young toddler falling asleep with his eyes half open and his foot tapping against the bed and he would automatically wake up when I left the room. His concentration was always short and I am not sure how he got through high school and part of junior college without reading a book all the way through. Smart as a whip, always an angle. Wish I had known before if he is ADD but maybe it is not to late.
oona
Posted by IsoM on April 14, 2002, at 1:04:43
In reply to Re: ADD diagnosis 1 week ago, completely calm now » katekite, posted by oona on April 13, 2002, at 22:18:22
Different places with diff doctors/psychologists will approach it in different ways. I was diagnosed by a pscyhologist (I had to pay out of pocket) by a detailed questionaire of family history, symptoms, etc & then had tests done to check my reponses with stimulation about & without (long & boring).
But just because I had a diagnosis done doesn't mean it was accepted by other doctors; & psychologists can't prescribe meds. They can recommend them but there's still a lot of doctors who think it unnecessary to give meds to adults. They ascribe to the idea either that people outgrow ADD, or that if you got this far in life without meds, you won't need them now. Finding a cooperative doctor is a real pain.
Posted by mike21 on April 14, 2002, at 10:04:54
In reply to ADD diagnosis 1 week ago, completely calm now » Michael K. Junk, posted by katekite on April 13, 2002, at 16:45:56
Kate,
I've read a couple of your posts regarding the stimulants helping to calm you. One of them in anther thread mentioned obsessive-type anxiety. Your description of thinking several thoughts at once sounds like me, too. Also, I have had relief of some symptoms from valium.
I am curious if any of your now-diagnosed "ADD" symptoms could fall under OCD, obsessive-compulsive disorder. I am starting to think there might be some similarities between these two disorders.
Have obsessions or compulsions ever helped you to cope with anxiety? I am asking because I am considering stimulants in the treatment of my anxiety, which I believe is OCD-mediated. Or perhaps I should reconsider my own diagnosis to be ADD.
Anyone else have any thoughts?
Mike
> Most people with ADD find stimulants really decrease their anxiety.
>
> I wouldn't know the meaning of the word euphoria, personally. And ritalin has really helped my feeling frantic and anxious all the time, frustrated with life and that life is harder for me than others. I had vague symptoms. With ritalin I feel relaxed physically and think slowly. I can tell when its time for the next dose when my brain starts to think several things at once, or only parts of thoughts. Jumping around.
>
> I have to be honest though, I've only been on it for a few days so I can't know if the effect will wear off. Diagnosed at the age of thirty. But my brother was diagnosed at 4. 41 years ago. I do not doubt the diagnosis whatsoever. I simply wasn't physically hyper. Instead I was tense. I say 'was' because ritalin has helped more in two days than any other drug I have ever taken. I say this and at the time say I do not feel happy. Rather I feel hopeful and a little disturbed over all the years I had to feel tense.
>
> To me ritalin feels almost identical to valium, except with the amount of valium I would have to take to be able to feel this relaxed I would also feel stupid or really sleepy.
>
> Certainly that is not the average response to speed. That is the ADD response.
>
> I have to say the reason it took me 10 years to try ritalin was because I myself really thought it was probably a pretty hokey diagnosis. That its so overdiagnosed, that yeah my brother definitely had it but that I didn't have every classic symptom and I did well in school so therefore it was a remote possibility.
>
> I am absolutely convinced now that it is underdiagnosed. If it took 25 years for me to get diagnosed there are others with milder cases who will never get diagnosed. Maybe its the modern diet, maybe its smog, maybe its drinking coffee in pregnancy, I have no idea. But it is a real thing.
>
> Sorry to rant. But I think everyone on any psychiatric medication deserves to have a real full evaluation. To get diagnosed properly to begin with. Try a continuous performance test. If you are going to be treated for life for anxiety issues or for depression its well worth the money to rule out ADD at the beginning.
>
> kate
Posted by katekite on April 14, 2002, at 10:48:16
In reply to Re: ADD diagnosis 1 week ago, completely calm now » katekite, posted by mike21 on April 14, 2002, at 10:04:54
Well that's an interesting question. My newest therapist (last six months) was just about to call my psychiatrist to discuss how much more like OCD he felt my thinking was than like pure anxiety. I say just about because I was being evaluated for ADD by a specialist, and then last week I walked into his office on ritalin and that theory went right out the window.
I used to pull my hair out as well, a 'soft' ocd trait. When I was working at the computer or reading or on the phone, but not while watching tv or while doing something 'fun'. I can not explain why I did it, but as of the day I started ritalin I have stopped. I started when I was 13 and have battled it ever since. Now its just gone.
I do not have traits like checking or washing etc. I did 'ruminate' or think repeatedly about the same subject. My mom seems to check things a lot, like whether the curling iron is on, and worry about those things and I suspect she has ADD (since my father does not, and my brother and I both do and it is so heritable).
I also found, and still find, the internet soothing. I think because its a manageable little world where distractions are predictable. I used to have a very very hard time stopping emailing, if I needed to do something or go somewhere. To the point my husband would ask if I needed the computer physically taken away and I would reluctantly say yes. Then he would, and I would feel very upset about it for some minutes until I switched tasks. Having trouble switching tasks can be a sign of ocd.
So I definitely have/had some ocd traits. I don't know how common that is in ADD, I don't know what purpose it served. It does seem to be much much different and better on ritalin in the course of a week. I feel much more relaxed.
I'm not sure to what extent these traits exist in general in untreated ADDers. Its possible that it simply is something unique to me, like I have a threshold for ocd behavior and when stressed by my untreated ADD it comes out.
Hope this helps.
kate
Posted by Ritch on April 14, 2002, at 11:16:11
In reply to Re: ADD diagnosis 1 week ago, completely calm now » katekite, posted by mike21 on April 14, 2002, at 10:04:54
> Kate,
>
> I've read a couple of your posts regarding the stimulants helping to calm you. One of them in anther thread mentioned obsessive-type anxiety. Your description of thinking several thoughts at once sounds like me, too. Also, I have had relief of some symptoms from valium.
>
> I am curious if any of your now-diagnosed "ADD" symptoms could fall under OCD, obsessive-compulsive disorder. I am starting to think there might be some similarities between these two disorders.
>
> Have obsessions or compulsions ever helped you to cope with anxiety? I am asking because I am considering stimulants in the treatment of my anxiety, which I believe is OCD-mediated. Or perhaps I should reconsider my own diagnosis to be ADD.
>
> Anyone else have any thoughts?
>
> Mike
>
Hi Mike,OCD is the most common comorbid psychiatric illness in families that have members with ADHD (from what I remember). OCD and ADHD are similar in some ways. If you think about it-both are "attentional dysfunctions" of different flavors. In OCD, people get "stuck" on a particular thought/ritual, whereas in ADHD your attention can't seem to stick to anything. Pschostimulants used for ADHD increase your ability to stay on a single task-whereas they can *diminish* your ability to rapidly "multi-task". SSRI meds that tend to help OCD, help to get your thoughts "unstuck" (in OCD), to relieve the anxiety. Psychostimulants (of the ones I have tried thus far anyhow) have mixed positive effects in relation to focus and single/multitasking. ADHD people have a tendency to "hyper-focus" on things they are interested in (without medication help), but can't stay on track with ordinary things. When I am involved in a task that I typically will "hyper-focus" on and I take a psychostimulant, sometimes it will make me *inefficient* with the task because I burn too much energy and time on it than the task requires. Stimulants improve efficiency with focus on tasks that come up that are everyday or routine (ordinarily quite boring) in nature (reading your mail-writing a check-filling out your taxes, listening and following directions, etc.) I have adapted to ADHD quite well. I looked at all of the "tips" and "tricks" on living with ADHD you can get from the NIMH, etc. and all of the things they suggest are methods I have already already adopted to keep myself on track (lists, notes to self, color-coding, etc.) Taking psychostimulants work quite well for my recurrent major depressions, but for everyday help with ADHD they actually impair my ability to rapidly multi-task on several things at once. Some things don't get done best all at one time.
Mitch
Posted by pharmer on April 14, 2002, at 22:45:37
In reply to Re: ADD diagnosis... OCD? » mike21, posted by Ritch on April 14, 2002, at 11:16:11
I was told by my pdoc that I have ocb - not full blown ocd. Asked what he ment by that and he said many patients have symptons that are clinicaly reconized as obsesive-compulsive"Behavior". Ocd is much more debilitating and a disorder in itself where as ocb is attributed to deppressive-gad.
Posted by jonh kimble on April 15, 2002, at 21:06:38
In reply to Re: ANYONE'S ANXIETY HELPED BY A STIMULANT? » dennison, posted by paxvox2000 on April 8, 2002, at 18:18:57
Hi, I know in my experience with social anxiety with some g.a.d, i have not responded to other anxiety agents. although anxiety is considered to be mediated through serotonin or gaba dysfunction, i believe that dopamine also plays a large yet unknown part, as it does in depression and social anxiety as well. this may explain why you do well on stims. i dont have any expereince with amisulpride, but it is totally a dopamine drug that benefits anxiety, social anxiety and depression. you may want to find out more about amisulpride, i know i sure do.
jon
Posted by mike21 on April 15, 2002, at 21:12:38
In reply to Re: ADD diagnosis... OCD?, posted by pharmer on April 14, 2002, at 22:45:37
Hi guys,
I find this discussion of OCD/OCB/ADD fascinating. I wish I had more time to give a proper response. Maybe in another day or so. Please stay tuned.
Mike
Posted by d miller on April 15, 2002, at 23:23:18
In reply to Re: ANYONE'S ANXIETY HELPED BY A STIMULANT? » dennison, posted by paxvox2000 on April 8, 2002, at 18:18:57
I have been reading things in this site for a few weeks.
The idea of stimulants working to help anxiety really interest me because I suffer from severe anxiety. I was told I have OCD 8 years ago and for the most part effexor had worked for me. It really helped with my anxiety and the OCD and depression in the past. I weaned myself off a year ago and this Janurary had a horribe relapse. Effexor is not working like it did before, and I have lots of axienty still.
Something I had kinda noticed was that on days that a drank a caffeine beverage like coke or moundtain dew I would start to feel better. For the most part I stayed away for caffiene because of everthing I read about it causing anxiety. But I wonder. I did mention this to my pdoc jokingly that I was oppisite girl and that maybe stimulants would work for me. She of course just looked at me stupidly, and prescribed clozapam for the anxiety which doesn't relieve it totally for me. It just makes so groggy all I want to do is take cat naps all day long. Who can do that?
d.miller
Posted by JohnX2 on April 16, 2002, at 16:56:58
In reply to Didn't Make Myself Clear » sid, posted by IsoM on April 9, 2002, at 22:43:26
> Sid, I reread my post to you & realised I didn't make something clear. When I say I wake up groggy, it's not a result of the stims - it's me naturally & taking something like Dexedrine doesn't counter it as when I wake up there's no Dexedrine left in my system, of course. But when I wake up from regular use of adrafinil, I don't wake up groggy. It seems to make my brain normal & I wake up like a normal person - groggy for about 5 minutes then properly awake. Hope I'm clear now.
Hi IsoM,
How does the Adrafinil compare to the Modafinil?
I tried Modafinil, but like every other stim or AD it crapped out on me in like 1 hr (followed by a crushing myofacial pain headache, just like Wellbutrin and Zoloft). Adderall would hold out if I took enough Klonopin with it; the Klonopin seemed to have an ability to prevent the development of tolerance.
John
Posted by JohnX2 on April 16, 2002, at 16:58:34
In reply to Re: Didn't Make Myself Clear » IsoM, posted by JohnX2 on April 16, 2002, at 16:56:58
> > Sid, I reread my post to you & realised I didn't make something clear. When I say I wake up groggy, it's not a result of the stims - it's me naturally & taking something like Dexedrine doesn't counter it as when I wake up there's no Dexedrine left in my system, of course. But when I wake up from regular use of adrafinil, I don't wake up groggy. It seems to make my brain normal & I wake up like a normal person - groggy for about 5 minutes then properly awake. Hope I'm clear now.
>
> Hi IsoM,
>
> How does the Adrafinil compare to the Modafinil?
>
> I tried Modafinil, but like every other stim or AD it crapped out on me in like 1 hr (followed by a crushing myofacial pain headache, just like Wellbutrin and Zoloft). Adderall would hold out if I took enough Klonopin with it; the Klonopin seemed to have an ability to prevent the development of tolerance.
>
> JohnOh, for the hour modafinil worked, it had a nice property of not driving me manic like adderall.
John
Posted by mike21 on April 16, 2002, at 19:24:07
In reply to mild ocd maybe yes » mike21, posted by katekite on April 14, 2002, at 10:48:16
For starters, I had OCD when I was about 8 years old. I've heard that when it occurs at such a young age it generally does not go away with behavioural/cognitive therapy, but that a med is probably required. The two symptoms I remember were washing and showering repeatedly, and choosing not to speak for periods of time.
I think the mutism was due to the anxiety from talking, and I think the washing helped to take away the anxiety. After a shower I would not talk for as long as possible. Sometimes I would even go to extent of using hand gestures alone to try to communicate.
I saw a psychologist which did nothing for me except to convince me that this behaviour was not really acceptable. So I remember one day deciding that if I ever hoped to stop seeing this guy, I would have to convince him I was cured. So I did, but I'd say that much of the anxiety I felt then is still present.
My current thinking is that OCD is based on a deficit in the pleasure centers of the brain. I seem to derive some sort of relief from my own general state of discomfort by repetitive thoughts, so much so that it is more uncomfortable to discontinue them. Maybe getting a circuit in the brain going generates more endogenous opioids, I don't know. But that kind of theory explains why some compulsions involve self-inflicted pain like hair-pulling or cutting. I've read about how treatment-resistant OCD'ers have had complete relief from their symptoms from just one weekly dose of morphine. Conversely, an opioid antagonist like naltrexone also works.
In the same respect, maybe a lack of attention could be due to a lack of positive feedback from certain dopaminergic pleasure centers of the brain. For example, social interactions are too variable to give a predictable reward, and the brain disengages itself. Like you, I find comfort in dealing with things in my own little contained world, like working on the computer. But after awhile, I get so locked in that groove, that getting out and interacting with others is difficult. I also get burned out and depressed- I think my brain just gets too tired from working at the same thing.
On the other hand, maybe OCD is an adaptation to ADD. It would make sense for someone with ADD to repeatedly check the curling iron to make sure it is turned off- it's probably been left on on more than one occasion! And obsessing could be the brains attempt at disciplining itself when it starts to wander. Perhaps people just have two opposing tendencies to react to the same basic brain chemistry- some people become AD/HD-manic while others go the route of OCD with comorbid depression, while others alternate between the two.
Given your success with ritalin and others success with opioids, it's suprising that I haven't heard more about a dopaminergic med for OCD. I've tried SSRI/SSNIs, they seem to make me even more capable of ocd behaviour.
Guess a stimulant would be worth a try.
Mike
> Well that's an interesting question. My newest therapist (last six months) was just about to call my psychiatrist to discuss how much more like OCD he felt my thinking was than like pure anxiety. I say just about because I was being evaluated for ADD by a specialist, and then last week I walked into his office on ritalin and that theory went right out the window.
>
> I used to pull my hair out as well, a 'soft' ocd trait. When I was working at the computer or reading or on the phone, but not while watching tv or while doing something 'fun'. I can not explain why I did it, but as of the day I started ritalin I have stopped. I started when I was 13 and have battled it ever since. Now its just gone.
>
> I do not have traits like checking or washing etc. I did 'ruminate' or think repeatedly about the same subject. My mom seems to check things a lot, like whether the curling iron is on, and worry about those things and I suspect she has ADD (since my father does not, and my brother and I both do and it is so heritable).
>
> I also found, and still find, the internet soothing. I think because its a manageable little world where distractions are predictable. I used to have a very very hard time stopping emailing, if I needed to do something or go somewhere. To the point my husband would ask if I needed the computer physically taken away and I would reluctantly say yes. Then he would, and I would feel very upset about it for some minutes until I switched tasks. Having trouble switching tasks can be a sign of ocd.
>
> So I definitely have/had some ocd traits. I don't know how common that is in ADD, I don't know what purpose it served. It does seem to be much much different and better on ritalin in the course of a week. I feel much more relaxed.
>
> I'm not sure to what extent these traits exist in general in untreated ADDers. Its possible that it simply is something unique to me, like I have a threshold for ocd behavior and when stressed by my untreated ADD it comes out.
>
> Hope this helps.
>
> kate
Posted by mike21 on April 16, 2002, at 19:50:39
In reply to Re: ADD diagnosis... OCD? » mike21, posted by Ritch on April 14, 2002, at 11:16:11
> > Kate,
> >
> > I've read a couple of your posts regarding the stimulants helping to calm you. One of them in anther thread mentioned obsessive-type anxiety. Your description of thinking several thoughts at once sounds like me, too. Also, I have had relief of some symptoms from valium.
> >
> > I am curious if any of your now-diagnosed "ADD" symptoms could fall under OCD, obsessive-compulsive disorder. I am starting to think there might be some similarities between these two disorders.
> >
> > Have obsessions or compulsions ever helped you to cope with anxiety? I am asking because I am considering stimulants in the treatment of my anxiety, which I believe is OCD-mediated. Or perhaps I should reconsider my own diagnosis to be ADD.
> >
> > Anyone else have any thoughts?
> >
> > Mike
> >
>
>
> Hi Mike,
>
> OCD is the most common comorbid psychiatric illness in families that have members with ADHD (from what I remember). OCD and ADHD are similar in some ways. If you think about it-both are "attentional dysfunctions" of different flavors. In OCD, people get "stuck" on a particular thought/ritual, whereas in ADHD your attention can't seem to stick to anything. Pschostimulants used for ADHD increase your ability to stay on a single task-whereas they can *diminish* your ability to rapidly "multi-task". SSRI meds that tend to help OCD, help to get your thoughts "unstuck" (in OCD), to relieve the anxiety. Psychostimulants (of the ones I have tried thus far anyhow) have mixed positive effects in relation to focus and single/multitasking. ADHD people have a tendency to "hyper-focus" on things they are interested in (without medication help), but can't stay on track with ordinary things. When I am involved in a task that I typically will "hyper-focus" on and I take a psychostimulant, sometimes it will make me *inefficient* with the task because I burn too much energy and time on it than the task requires. Stimulants improve efficiency with focus on tasks that come up that are everyday or routine (ordinarily quite boring) in nature (reading your mail-writing a check-filling out your taxes, listening and following directions, etc.) I have adapted to ADHD quite well. I looked at all of the "tips" and "tricks" on living with ADHD you can get from the NIMH, etc. and all of the things they suggest are methods I have already already adopted to keep myself on track (lists, notes to self, color-coding, etc.) Taking psychostimulants work quite well for my recurrent major depressions, but for everyday help with ADHD they actually impair my ability to rapidly multi-task on several things at once. Some things don't get done best all at one time.
>
> MitchI'm glad you pointed out that they were comorbid- it had never occured to me that they could be so closely related, just because they seem at opposite ends of the psychological spectrum. But after obsessing, I mean thinking, about it I've come up with some theories (see above post).
From what you say about burning up too much energy on a task, I'd have to say that I do that already. It is more due to perfectionism than anything. Sometimes with a boring task, getting it as perfect as possible gives me a feeling of accomplishment and reward.
I do have a hard time multi-tasking in terms of getting things done in the physical world- I tend to seek out things I am interested in, at the expense of other "boring" things that really *need* to get done.
When you say you burn up too much energy than the task requires, does that mean you become perfectionistic?
Mike
Posted by IsoM on April 16, 2002, at 22:48:04
In reply to Re: Didn't Make Myself Clear--IsoM, posted by JohnX2 on April 16, 2002, at 16:58:34
If you can't take modafinil (Provigil), John, you probably wouldn't be able to tolerate adrafinil either. Remember that one of adrafinil's metabolites is modafinil. Unless there's something helpful or protective of the other main metabolite of adrafinil, the fact part of it changes to modafinil would probably count it out for you.
You said you had an hour of it working before you got a massive headache. What dose had you taken? I find it surprising when people say they notice an immediate affect with Provigil or adrafinil. It took fully a week for me to notice a difference & then it continued improving over the next month. I'm wondering if you started with a lower dose (perhaps even 1/4 of normal) & worked it up to 1/2 the next week, then 3/4 the following week before reaching the full dose, if it might work better.
Zo mentioned that she found Provigil has a fairly narrow therapeutical window & beyond it, side-effects show & negate the benefits. Less than that, it didn't seem to work. Your therapeutical window might be much lower than what's 'normal'. Seeing you probably have Provigil still kicking about, why not give it a try again at 1/4 normal dose on a weekend when you can crash from the pain, if it happens.
Remember how it doesn't seem to have any strong affinity for any neurotransmitter but seems to increase over-all brain metabolism? Perhaps too much increases someplace in your brain that affects your perception of pain?
Muscle relaxation & the mental calmness I feel with adrafinil was one of the last benefits to kick in. For me, it was very noticable when it did. I realised that I could be alert & bright without being tense with muscles like coiled springs. My shoulders were no longer slightly hunched, no furrowed brow, tightly held jaw, or madly tapping toes & swinging legs. My body was still & relaxed but I was alert & ready. The only other time I ever felt so relaxed was when I'd awake in the morning & then slip back into sleep. I never equated calm with alert before.
Anyway, if you can tolerate it in a lowered dose, be patient about feeling the full benefits of it. Most reports I've read said it takes a while for them to happen.
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