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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by Noa on October 15, 1999, at 2:50:41
My pharmocologist introduced a thought that intrigues me. He said he thinks I have ADHD. I happen to be familiar with ADHD from my work, an am skeptical, but interested. His thought stems from how I react to medications. I have to ask him to give a more detailed account of his reasoning, tho, as there wasn't time in our 15 min. meeting. A lot of my problems as a kid could be explained equally, perhaps even more convincingly, as a result of depression and anxiety (daytime eneuresis, not finishing projects, nightmares, low self-esteem, etc.) I did not have school problems until high school, and tho these were due to poor study habits and disorganization, writing phobia, etc., which one could possibly construe as being related to ADHD, could also be attributable to my internal distractions. I was definitely depressed in high school. Lately, I have more problems that could be seen as ADHD--have become extremely disorganized, unable to focus on things I generally like, such as reading, etc., and on meds, the fidgety, hyper feelings. I don't know.
Posted by jamie on October 15, 1999, at 3:37:41
In reply to Diagnosis puzzle, posted by Noa on October 15, 1999, at 2:49:29
Noa it sounds like depression to me. But whether its really ADHD or depression might be irrelevent because the treatments are similar. Results is all the matters right? Psychostimulants are used for ADHD. They are also used in depression. Wellbutrin is used for ADHD too. It seems to me there is quite a bit of overlap in the treatment of the two conditions. Even if the diagnosis had been something else like psychosis, antipsychotics can work for depression. I think all the mental disorder drugs have the potential to treat depression, and thus the actual diagnosis may not be that important. As you know its hit-and-miss with drugs. Maybe a ADHD drug will work great for you whether or not you actually have ADHD. Just somethin to ponder.
Posted by Bob on October 15, 1999, at 6:30:00
In reply to Re: Diagnosis puzzle, posted by jamie on October 15, 1999, at 3:37:41
Okay, Noa, we just gotta stop this right now about the brain bin stuff.
I've been putting off getting tested for ADHD/ADD or some other learning disability because even if I have one, I've been able to get around it rather successfully most of the time. But not all of the time. Jamie's right about the overlap -- just look how many people on this board have the dperession/ADD combination?
Well, you've convinced me to give a buddy a call. He's a school psychologist, and has quite a bit of expertise in testing for this stuff. Maybe he has some tests that apply for adults ... I'll let you know.
Bob
Posted by Julie on October 15, 1999, at 18:13:13
In reply to Re: Diagnosis puzzle, posted by Bob on October 15, 1999, at 6:30:00
> Okay, Noa, we just gotta stop this right now about the brain bin stuff.
>
> I've been putting off getting tested for ADHD/ADD or some other learning disability because even if I have one, I've been able to get around it rather successfully most of the time. But not all of the time. Jamie's right about the overlap -- just look how many people on this board have the dperession/ADD combination?
>
> Well, you've convinced me to give a buddy a call. He's a school psychologist, and has quite a bit of expertise in testing for this stuff. Maybe he has some tests that apply for adults ... I'll let you know.
>
> BobHi guys...
I am a longtime lurker and could not resist responding. Sounds like what I've been thru as well. I compensated fine (for the ADD) a very long time, altho' I believe it was draining and anxiety provoking now that I look back.
I too was treated initially for depression, but soon suspected there was something else goin' on. I am now on both AD's and stimulants and doing much much better..
Julie
Posted by Bob on October 15, 1999, at 19:39:23
In reply to Re: Diagnosis puzzle, posted by Julie on October 15, 1999, at 18:13:13
> Hi guys...
> I am a longtime lurker and could not resist responding ... I too was treated initially for depression, but soon suspected there was something else goin' on. I am now on both AD's and stimulants and doing much much better..
> JulieThanks for chiming in, Julie! =^)
Went to see my buddy but, of course, he was out of his office. Well, I guess that's what voice mail is for....
Bob
Posted by Elizabeth on October 15, 1999, at 19:53:48
In reply to Diagnosis puzzle, posted by Noa on October 15, 1999, at 2:50:41
I don't know about ADHD, but something else caught my eye. You mentioned "writing phobia." Exactly what do you mean by this? I don't get "test anxiety," but I do have "homework anxiety" (in fact, at this very moment I'm avoiding a lab report that I know I can do easily if I can just get started). It really slows me down - I just feel paralyzed.
I wonder if this sort of thing is a problem for anyone else, and if anyone knows what to do about it.
Oh, one thing about ADHD and depression - they tend to go together, but the courses are different, ADHD being pretty much a chronic, continuous thing and depression being more sporadic. For whatever that's worth. I don't think the diagnosis matters so much - a better question might be, should you try stimulants? I don't know the answer to that.
Posted by Noa on October 15, 1999, at 20:44:12
In reply to Re: Diagnosis puzzle, posted by Bob on October 15, 1999, at 19:39:23
I have never had any psychoeducational testing, other than a "draw a person" screening to get into kindergarten (interestingly enough, I remember this encounter with the school psychologist, and remember clear as day that my "person" was a *man*--something I hope would not have happened if I were five years old today and not 34 years ago!!) Am curious as heck about how I would test.
BTW, spoke to my younger brother today and found him at wits end about my niece, age 9, who appears to have a whopping anxiety disorder--refuses to eat (this comes and goes, sometimes it is about limiting to certain kinds, colors, consistencies of food, etc), worries all the time, and get this, *picks at her scalp* (see my previous post). I didn't have the nerve to tell my brother his daughter has my genes.
Posted by Noa on October 15, 1999, at 20:54:09
In reply to Re: Diagnosis puzzle, posted by Elizabeth on October 15, 1999, at 19:53:48
Am already on ritalin, as an augmenter to effexor, so perhaps you are all right in saying the dx is moot.
re: writing phobia--I had it bad, real bad. I used to procrastinate doing homework, esp. any kind of writing, until the deadline was so near, or so overdue, that the adrenaline had to kick in big time. I hated the mad rush of adrenaline and anxiety, but it was the only thing that got me to do the work. I would get so stuck feeling like I didn't know how to start, had nothing to say, etc. I still have this problem with anything that I feel will be read and evaluated (like at work), but after college and grad school, I started writing bit by bit. When I went back to school in my late twenties, computers were on the scene and that was a life saver. Somehow I could convince myself to write first and edit later, rather than paralyze myself.
Posted by Elizabeth on October 16, 1999, at 6:37:08
In reply to Re: Diagnosis puzzle, posted by Noa on October 15, 1999, at 20:54:09
> Am already on ritalin, as an augmenter to effexor, so perhaps you are all right in saying the dx is moot.
Neat. How's that going?
I can't believe you have the same phobia I have. My pdoc calls it performance anxiety, so maybe propranolol or something like that would help? (I've tried all the tricks I know of to convince myself of something that I don't really believe!)
Posted by S. Suggs on October 16, 1999, at 7:15:53
In reply to Re: Diagnosis puzzle, posted by Bob on October 15, 1999, at 19:39:23
This really sounds like me. I have played hit and miss with AD's and stims over the past 5 years. I do a combination of a ssri and lithium. This seems to work well, however, I am considering a complete round of tests on my thyroid. I know that you can have "normal" test results and still be hypothyroid. The symptoms of hypothyroidism are so close to depression / ADD that it is impossible at times to tell them apart. And by the way, several of the symptoms of hypothyroidism are depression, inability to concentrate, irritibility etc...
Also, as I am making this post, my wife just told me that her best friend (teacher-early childhood/special needs)told her that they check the back of the children's shirts to see if the tag has been cut out. Obviously a non-proven diagnostic test for ADHD, but it must point to the fact that the tag is a distraction and therefore must be removed? By the way, I have been removing the tags from my shirts for years.
S. Suggs
Posted by Noa on October 16, 1999, at 11:22:23
In reply to Re: Diagnosis puzzle, posted by S. Suggs on October 16, 1999, at 7:15:53
I sometimes remove tags, the papery ones bother me. I tend to be easily overstimulated by sights and sounds. Also, tactily defensive at the throat/neck. Lately, sounds are really a problem--they seem much louder to me than other people report. I know for a fact that movies are actually louder than they used to be, but it doesn't seem to bother other people, while for me, it feels like an assault. At work, the PA system jangles my every nerve ending. I tend not to like malls too much, tho I have learned to cope with them when needed. I tend to shop like a man--search and hunt down, rather than browse and dabble and touch everything, like a woman--because I don't like the way malls bombard all of my senses. Some malls are beginning to change design so they are less overwhelming, more natural light, etc.
Posted by Noa on October 16, 1999, at 11:34:11
In reply to Re: Diagnosis puzzle, posted by Elizabeth on October 16, 1999, at 6:37:08
The ritalin helps, but now that I am less depressed, I am definitely noticing the ritalin rebound thing when it wears off. Feel too much mood variation during the course of the day. I might try the SR at some point and see if it makes a difference. When I first started taking the ritalin it made a WORLD of difference because at the time I had untreated obstructive sleep apnea, and was constantly exhausted (which I attributed to the depression). With the ritalin, I could stay awake and not have to constantly ply myself with strong coffee. Once the apnea was dxed and txed, the sleepiness was no longer an issue, but I continued to take the ritalin because it helped augment the effexor, larger doses of which I don't tolerate well (tics and twitches, sleeplessness). But here I am back up on a high dose of Effexor because my depression got worse because it was not fully treated all that time. The xr version of effexor doesn't cause as many problems as the regular, but still, I am begining to get annoyed with the fidgetiness. I still need to try exercising regularly to see if that helps. If it doesn't I will ask my pdoc to explore a different variation of the cocktail.
Posted by Dee on October 16, 1999, at 12:34:15
In reply to Re: Diagnosis puzzle, posted by Noa on October 16, 1999, at 11:34:11
(I know I said I wouldn't be posting for a while, but...)
There's a book about separating the 'editor' and the 'creator' as we write. It is called 'Writing Down the Bones' by Natalie Goldberg, and it is much thanks to that book that I can write at all.
XXX ~;o)
Dee
Posted by Bob on October 16, 1999, at 16:49:51
In reply to Re: Diagnosis puzzle, posted by Dee on October 16, 1999, at 12:34:15
Looking at putting off academic tasks from a more psychological point of view (vs. a neuro POV), you should try looking at it in terms of task definitions and intermediate goal states.
And now, without the technobabble,
Same thing would happen with me. I tend to see tasks as these monolithic jobs with high demands on my time and skills and high stakes at risk in the outcome. What helps me is to break the task down into subtasks, and focus only on one at a time. You have to start by taking baby steps -- small bites of the whole task at a time. When you finish one part, reward yourself. You really should, if you've started working right away and have made progress towards finishing. Whether that means a ten minute break, some ice cream, whatever, give your nerves a chance to back off and calm. Then move to the next step. Chart your progress -- once you start seeing that you are making good progress on the whole and feeling like you are doing so successfully, just getting each intermediate step done can become rewarding in and of itself.
Bob
Posted by Elizabeth on October 16, 1999, at 19:14:54
In reply to Re: performance anxiety, posted by Bob on October 16, 1999, at 16:49:51
Bob,
I've tried this approach, not specifically with a mind to performance anxiety but just study skills in general. I always break things down into small tasks; doesn't help if you're too paralyzed to start in the first place! My attention probably is too poor to permit me to treat each step as a black box, anyway. I've never found that artificial "rewards" helped with anything for me, including studying.
Thanks, though.
Posted by Bob on October 16, 1999, at 21:51:14
In reply to Re: performance anxiety, posted by Elizabeth on October 16, 1999, at 19:14:54
> ... I've never found that artificial "rewards" helped with anything for me, including studying.
Same here, unless it's something that is a true break from the stress. When I hit something that stops me dead in the water, just the process of breaking it down and completing a part is highly stressful for me. So, for me, its not so much as "Yea! Ice Cream!" as "Thank God I got through that! I need a break ... a nice break." Of course, it gives me an opportunity to distract myself, but I just get too high-strung without those breaks and I wind up bouncing (one leg, both legs, arms, entire body...) to the point of distraction.
Bob
Posted by Dee on October 16, 1999, at 23:04:45
In reply to Re: performance anxiety, posted by Bob on October 16, 1999, at 21:51:14
I find that I have hard time focusing on the task at hand, because I am too concerned about the results. Somehow, I sometimes manage to separate the two. I have a very good friend who always reminds me that I am responsible for the effort, but not for the outcome.
Somehow, when (if) I manage to narrow my focus, I find that I have spend days and days avoiding a small assignment that really is nothing at all. Yet next time I fall in to the same routine of avoidance and fear.
Dee.
PS. I am a babble addict - I said I would stop but I cannot! Help!
Posted by dj on October 16, 1999, at 23:52:46
In reply to Re: performance anxiety, posted by Bob on October 16, 1999, at 21:51:14
Just like Bill Gates, Bob? I'd go for the bouncing msyelf in exchange for a portion of his assets!!
> ... but I just get too high-strung without those breaks and I wind up bouncing (one leg, both legs, arms, entire body...) to the point of distraction.
>
> Bob
Posted by dj on October 16, 1999, at 23:59:55
In reply to Re: performance anxiety, posted by Dee on October 16, 1999, at 23:04:45
Unfortunately it all sounds too familiar...I can always find something more interesting to do or something distracting while putting off the importants tasks, like balancing my finances or getting assignments done in a timely manner. Instead I often get locked in paroxyms of self-doubt, anxiety and further avoidance. A nice pattern for nurturing self-hate, depression and all those less than desirable attributes, indeed.
And it's much easier to read & write about it then actually do something about it, too often...hence P-Babble can just be another means of procrascination, at times, though ofen an en-light-ening one.
> I find that I have hard time focusing on the task at hand, because I am too concerned about the results. ... Somehow, when (if) I manage to narrow my focus, I find that I have spend days and days avoiding a small assignment that really is nothing at all. Yet next time I fall in to the same routine of avoidance and fear.
>
Posted by Susan on October 17, 1999, at 6:42:23
In reply to Re: performance anxiety, posted by dj on October 16, 1999, at 23:59:55
All I have to say to this string of posts is--DITTO!
Posted by dj on October 17, 1999, at 9:15:36
In reply to Re: performance anxiety, posted by dj on October 16, 1999, at 23:52:46
Take a look at the thread above on Dilantin aka Phenytoin & Brandon's comments on how after a few days he is noticing an impact on performance anxiety...though if anyone was to pursue this as part of their pharmacopeia I suggest you research the side effects as I believe their are some strange impacts from sustained use, as there maybe from many of these foreign substances...
Posted by Noa on October 17, 1999, at 11:09:07
In reply to Re: performance anxiety, posted by Dee on October 16, 1999, at 23:04:45
Dee, if you are addicted to babble and trying to quit, you'll get no help from me, cause I love having you around.
I love having all of you guys around.
Posted by kjm on October 18, 1999, at 21:04:53
In reply to Never been tested..., posted by Noa on October 15, 1999, at 20:44:12
> BTW, spoke to my younger brother today and found him at wits end about my niece, age 9, who appears to have a whopping anxiety disorder--refuses to eat (this comes and goes, sometimes it is about limiting to certain kinds, colors, consistencies of food, etc), worries all the time, and get this, *picks at her scalp* (see my previous post). I didn't have the nerve to tell my brother his daughter has my genes.
Hi Noa,
Just a quick thought for you regarding your niece:
from your description, she may have a form of OCD
(obsessive compulsive disorder).
And like ADD, Depression, Panic Disorder,
it may respond well to an SSRI !cheers,
kjm
Posted by Bob on October 18, 1999, at 23:42:07
In reply to Re: Noa's niece.., posted by kjm on October 18, 1999, at 21:04:53
> I didn't have the nerve to tell my brother his daughter has my genes.
Now, that would be some trick. ;^P
My younger brother has two kids in their tweens who are just tearing up middle school academically -- I keep telling him they have my genes ... but that would be a bit more plausible....
Bob
Posted by Noa on October 25, 1999, at 20:37:39
In reply to Diagnosis puzzle, posted by Noa on October 15, 1999, at 2:50:41
> My pharmocologist introduced a thought that intrigues me. He said he thinks I have ADHD.
I have thought about this a lot in the past week or so, and have decided that there is not much to support the idea that I have ADHD. A lot of the symptoms I have had at various points in my life point more in the directio of anxiety and depression. In kids, especially, there are many symptoms that can suggest ADHD but can also be caused by anxiety/depression. Probably, these distinctions in diagnosis are unnecessary for most people, anyway, since different illnesses can disable the functioning of the same parts of the brain, same neurotransmitters, etc.
This is the end of the thread.
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