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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by jealibeanz on November 13, 2006, at 21:26:06
Hi, I'm a 23 yr old intelligent grad student. However, I am struggling a great deal in school. I have difficulty listening to lectures, retaining information, studying notes, or reading for more than a few minutes without getting up and moving on to a new task or getting sleepy. This is honestly not even a conscious decision. It's almost as if I forget I was trying to study.
I have very high reading comprehension skills and language skills. This is not the problem. I know it is my ADHD (inattentive). I'm about to fail out of school because of this. I need to speak to my director about the fact that they may be asking me to leave, and will obviously have to give an explaination.
I don't know whether to mention ADHD directly or just describe the symptoms. She should pick up on it, as she's in the medical field, but may not. I think she tends to think that I'm either lazy, unmotivated, depressed, or anxious, leading to poor performance.
I never went through formal 6 hour testing like most kids because I only because aware of the problem a few years ago. Structural defects in my prefrontal cortex were measured using special instruments. I underwent biofeedback therapy for a while, but then seemed to max out it's benefits.
My primary care physician has prescibed me Adderall (horrrrible... caused major depression). My PA prescibed Straterra (mildly effective at first, lost it's zest, and sliiiightly depressing). None of these were done under formal testing, so my prof may not believe me because I don't have a certificate or whatever you get!
Right now I take Provigil for fatigue. Some people with ADHD are helped by this, for me, it simply keeps me awake.
I don't know if I want to just throw out the ADHD label or not. I'm not medicated right now. Possibly if I were things would improve. Right now I'm the classical underachiever (although not tooo bad, I have much much more potential than I'm able to access). She may just thinks it's a load of crap and that I need counseling, not medication, since I'm intelligent and a lot of people don't believe intelligent people who graduate from college could possibly have ADHD.
It's such a sensitive subject for me. I don't want to bring it up. But I also don't want to throw away the chance of being successful with proper treatment.
Posted by med_empowered on November 13, 2006, at 22:46:50
In reply to I need advice by tomorrow morning! :(, posted by jealibeanz on November 13, 2006, at 21:26:06
it depends (I assume you're talking about a shrink here). I mean, if you have been previously treated then she should look at that as an indication of a valid DX. If she doesn't recommend what you want to do, see someone else. Counselling can help if you have any other stuff going on, and they may be able to do some kind of CBT stuff or awareness training to improve things.
Good luck
Posted by stargazer on November 13, 2006, at 23:56:31
In reply to I need advice by tomorrow morning! :(, posted by jealibeanz on November 13, 2006, at 21:26:06
You have a medical condition that is preventing you from finishing your studies, that's very serious especially since you say you are an intelligent person who has always done well before now.
What do you have to lose? I think you will lose more if you don't speak to this director immediately and explain what you are going through. You don't have to give the exact diagnosis unless you want to but you have to let them know you are under the care of a physician who is adjusting your medications, etc.
A medical condition like ADHD, depression or cancer can always relapse and until it gets back under control, it can prevent you from being able to keep up with the demands in your program.
For all you know, they already suspect something is not right, but better you explain the legitimate situation, trahter than having them suspect you are lazy, unmotivated or worse, on drugs or alcohol.
All of this should be considered a confidential matter and should not affect your standing in the program especially since you have done so well before now. It only helps your situation by speaking to the right person, in confidence, to explain what you are dealing with. I don't see any other option based on your distress and
need for medical management.Good luck.
Posted by stargazer on November 14, 2006, at 0:08:54
In reply to Re: I need advice by tomorrow morning! :(, posted by stargazer on November 13, 2006, at 23:56:31
BTW...I'm also an intelligent (I think) college grad with ADHD and Depression, I struggled through my studies too...I never did as well as I could have, have never been able to focus, read or comphrehend very well...didn't know why until many years later. ADHD and depression were not treated back then and were never talked about openly. I graduated from college but did not get an advanced degree probably since I struggled constantly due to my lack of attention and focus.
Don't be ashamed of your condition...just make sure to get it under control so you can continue with all of your aspirations. You sound like a very responsible person who can get throguh this.
SG
Posted by jealibeanz on November 14, 2006, at 1:11:21
In reply to Re: I need advice by tomorrow morning! :(, posted by med_empowered on November 13, 2006, at 22:46:50
A shrink? No... ewwww I that word anyway! :) I'm being cared for by my very much trusted GP.
At the moment, as far as this situation is concerned, I do not need counseling. I do have anxiety, much it is well controlled and does not hinder my progress in any way.
Posted by jealibeanz on November 14, 2006, at 1:12:13
In reply to Re: I need advice by tomorrow morning! :(, posted by stargazer on November 14, 2006, at 0:08:54
Posted by lymom3 on November 14, 2006, at 9:27:42
In reply to How much can the correct medication help? (nm), posted by jealibeanz on November 14, 2006, at 1:12:13
A LOT! You are so stressed that you've forgotten, I think what it's like to be semi normal. Honesty is always the best thing to do. If Adderall didn't work, try Ritalin, Focalin. You are just worn out right now. Try to remember that. You are in control of meds. If one of those doesn't suit you, you don't have to take it.
My middle son was never medicated properly until he was 17 and in trouble at that point. We found the right pdoc and the right meds and he is such a different kid. He knows that he won't make it in life without his meds and that is a huge leap from the kid who wouldn't even take them.
They know you're having trouble. Talk to them honestly without trying to put your good front on. Let them know that you don't have it as together as you portray. It's hard to let yourself be vulnerable but it might be your best course of action....
Good luck though. We all know how hard you've been struggling.
Posted by jealibeanz on November 14, 2006, at 14:18:03
In reply to Re: How much can the correct medication help?, posted by lymom3 on November 14, 2006, at 9:27:42
Yeah, but the problem is, I actually should be kicked out of school right now based on their standards. I actually might be within the next day or so. And I only have a month left of this semester. Not enough to get a doc appt, proper meds, and learn an entire semesters worth of info before finals in 2 and 3 weeks.
Posted by lymom3 on November 14, 2006, at 14:32:57
In reply to Re: How much can the correct medication help?, posted by jealibeanz on November 14, 2006, at 14:18:03
Do you have a way to deal with that if it happens? Obviously you have education and are intelligent, you won't be unable to support yourself, but mentally can you be ok with that? Do you have a support system? I'm sure on some level it might almost be a relief but on the other hand it would be devastating. I'll be thinking about you...take care of yourself.
Posted by B2chica on November 14, 2006, at 15:07:20
In reply to Re: How much can the correct medication help?, posted by jealibeanz on November 14, 2006, at 14:18:03
> Yeah, but the problem is, I actually should be kicked out of school right now based on their standards. I actually might be within the next day or so. And I only have a month left of this semester. Not enough to get a doc appt, proper meds, and learn an entire semesters worth of info before finals in 2 and 3 weeks.
if you're really feeling this way i think you should definately talk with the right person and tell them what is going on. this could avoid you're being 'kicked out', but may allow you to put your education on hold for a semester or two.
a few years ago i was working on my graduate degree and had several hospitalizations and finally realized i had to choose one or the other, i talked to my professors who were amazingly supportive, i took incompletes in my classes and finished them on my own time and took about a year hiatus from other classes until my meds got situated and my therapy was helping.
i've since finished my thesis/research and graduated.
it took me longer than i would have liked, but i did both! took care of me, AND finished my goals.
you can too. but i think you really should focus on yourself right now, i think all school is managing to do for you right now is increase your anxiety and make studying worse, thus increasing anxiety...etc.
best wishes.
b2c
Posted by Phillipa on November 14, 2006, at 16:15:59
In reply to Re: How much can the correct medication help? » jealibeanz, posted by B2chica on November 14, 2006, at 15:07:20
I think B2chica has a very good point. Love Phillipa
Posted by jealibeanz on November 14, 2006, at 20:32:02
In reply to Re: How much can the correct medication help? » jealibeanz, posted by B2chica on November 14, 2006, at 15:07:20
That's definitely the best option, unfortunately, it doesn't work that way. I'm in a specialized program with a class of 30. We enter together, take all the same classes, and graduate together. I can't stop and start as I please. Next year's classes are for next year's class. There's no room for movement or error. I wouldn't be allowed to defer and they would not accept me in another class. I know this as I had asked months ago for another reason. Also, credits for my major don't transfer to other schools. It's a universal concept. You must complete the program at your school, and it's typically about 12 months of nonstop grad classes at 18 credits a semester. I'd have little chance of being accepted at any other school for this major because they'd know I dropped midway from another.
Posted by B2chica on November 15, 2006, at 10:27:31
In reply to Re: How much can the correct medication help?, posted by jealibeanz on November 14, 2006, at 20:32:02
sorry to hear it's such a strict program. but i think that's even more of a reason to speak with a 'higher-up' person. you can't tell me that a certified program doesn't have assistance for persons with disabilities, or medical emergencies. that's not allowable if it is a legit program. they can't just tell you that if you don't continue on you can never graduate. there must be provisions (federal guidelines). they may not be the best, or even ones that would work for you...but they MUST be implemented.
so sorry for your situation. please talk with someone, at least you won't be sitting on your thumbs anxiety rittled about what to do. youwill be doing something, then it's in their hands.
be gentle with yourself.
good luck.
b2c.
> That's definitely the best option, unfortunately, it doesn't work that way. I'm in a specialized program with a class of 30. We enter together, take all the same classes, and graduate together. I can't stop and start as I please. Next year's classes are for next year's class. There's no room for movement or error. I wouldn't be allowed to defer and they would not accept me in another class. I know this as I had asked months ago for another reason. Also, credits for my major don't transfer to other schools. It's a universal concept. You must complete the program at your school, and it's typically about 12 months of nonstop grad classes at 18 credits a semester. I'd have little chance of being accepted at any other school for this major because they'd know I dropped midway from another.
Posted by Caedmon on November 19, 2006, at 7:45:26
In reply to Re: How much can the correct medication help? » jealibeanz, posted by B2chica on November 15, 2006, at 10:27:31
> you can't tell me that a certified program doesn't have assistance for persons with disabilities, or medical emergencies. that's not allowable if it is a legit program. they can't just tell you that if you don't continue on you can never graduate. there must be provisions (federal guidelines). they may not be the best, or even ones that would work for you...but they MUST be implemented.>
Yep, exactly. That would be a violation of your rights under the Americans w/ Disabilities Act and Section 504.
However, you must have a documented disability and you should have it documented through your school's disabilities resource center.
I am in a similar situation, contemplating whether or not it is even feasible to stay in a very very tought graduate program (10-15 graduate credits + clinical practicum + TAship!). I am choosing to do something other than the lockstep program, because taking that many graduate credits is too much for me.
Please see:
http://www.bu.edu/cpr/jobschool/- Chris
Posted by jealibeanz on November 19, 2006, at 10:45:07
In reply to Re: How much can the correct medication help? » B2chica, posted by Caedmon on November 19, 2006, at 7:45:26
Yes, you're right, I most likely could get some sort of exemption. However, I'd have to retake a whole year's worth of courses ($25,000+). That's a big decision when you already have major student loan debt!
Posted by Caedmon on November 19, 2006, at 14:13:18
In reply to Re: How much can the correct medication help? » Caedmon, posted by jealibeanz on November 19, 2006, at 10:45:07
Posted by jealibeanz on November 19, 2006, at 23:29:47
In reply to I know *exactly* what you mean! :-| (nm) » jealibeanz, posted by Caedmon on November 19, 2006, at 14:13:18
Yeah... it's tough to make major personal progress and finally get this far in life, to the point where you think you're actually becoming a responsible/successful/"normal" adult and student. Then, fall flat on your face!
I never thought that my academic abilties would stand in my way. My problems were always blamed on anxiety, but I suppose part of that anxiety has roots in my ADHD.
Chris, I know you mentioned that you suspected some ADHD at one point, did you ever get this dx? Are you actually required to do your TA-ship, internship, plus full grad load simultaneously? It's sounds like you have more flexibility and options than me (haha, since I have noo choices whatsoever beside take the 18 credits the school signs us up for, then, stay and pass, or fail and leave!)
I think about leaving evvvvvvery day. I only have 2 days til Thanksgiving break, and I just wanna quit. I have a retake exam because I failed one and that causes some great stress! Plus the stress of knowing that I have several courses where I have to take a comprehensive final since my grades are poor. And the other finals won't be too easy either.
Right now, my brain seems "short-circuited". It doesn't quite get that study/learning type of focus that I need. Plus, I'm wandering like crazy around my apartment and town, forgetting what I'm doing or creating new useless tasks. God, I need a break and some proper medication!
Do you have any suggestions as to how to approach my doc? I do have a good relationship with him. He's very fatherly, extremely friendly, enthusiastic, caring, and empathetic. He'll listen to every one of my stupid complaints and side effects, when most docs would blow them off, saying it's not common, or that I might as well never try any med again since I'm very sensitive.
However, I just have problems getting the ADHD words out. I don't want to tell him I'm doing poorly. And one of the hardest parts I have about ADHD, especially since I'm an adult, is that it is chronic. I just want to ignore it and pretend it will go away, but it won't! The only thing that gives me a little comfort is that I'm pretty sure he has ADHD (not always very well controlled, but I still trust our relationship enough to go to him), so unless I'm wrong, he doesn't think it's abnormal for problems to only fully manifest when in grad school.
As much as there's been a huge compaign for depression tx, and kids have been treated for ADHD for years, the adult type is still almost not thought to exist by many practitioners. If they are willing to treat, they wanna throw a non-stim at you.
My thought... the reason why more adults are being treated currently is 1) they were treated as children and are continuing 2) increased awareness in mental health 3) many seek treatment after diagnosis of a child 4) the hectic, overachieving expectations of our society are uncovering many ADHD'ers who were able to cope in a more laid back society
(side note: kinda like I hate saying the word depression, and for once that's actually not in the back of my mind... haha during psych class my instructor tells us to ignore all the sleep/mood disorder symtoms... since it's completely normal for us to have irregular sleep, major anxiety, depression (or at least a stressed-out, life sucks, I hate my school/my life/my class mates and I wanna go home type of mimicked depression... so I'm not too worried about that right now).
Posted by Dr. Bob on November 22, 2006, at 9:38:14
In reply to Re: I know *exactly* what you mean! :-| » Caedmon, posted by jealibeanz on November 19, 2006, at 23:29:47
> Chris, I know you mentioned that you suspected some ADHD at one point, did you ever get this dx? Are you actually required to do your TA-ship, internship, plus full grad load simultaneously?
It's fine to keep discussing the treatment of ADHD here, but I'd like to redirect follow-ups regarding TA-ships, etc., to Psycho-Babble Students. Here's a link:
http://www.dr-bob.org/babble/studs/20060709/msgs/706122.html
Thanks,
Bob
Posted by jealibeanz on November 22, 2006, at 21:57:45
In reply to I need advice by tomorrow morning! :(, posted by jealibeanz on November 13, 2006, at 21:26:06
I did go to my appointment today. Thinking back, it was strange. The nurse asked me if I was there for a recheck, so I just said yes. Haha, I'm not sure what my doctor knew, maybe thought that it was a recheck, even though I was there two weeks ago and was supposed to go back in January.
So as always we begin by talking about school, nothing medically related to myself. He casually asked how school was going, while doing something, expected just the plain old "good", with an enthusiastic smile. And then I added, I'm probably not going back. Haha, he immediately stopped and looked at me in shock!
We talked about it and he did make me feel much better. I told him about my academic problems and the school's problems. He's very empathetic since he understands what I'm going through. I always come out of our visits with renewed hope. In some way, he's the only reason why I've stayed (He is giving my psych meds, but it's the relationship, and seeing his own happiness and fulfillment that makes a difference). It would be so nice for me to come back and tell him in ten years that he's the only thing that kept me going. (As I introduce him to my husband and our first baby, and tell him how much I love my job)
Anyhow, as an afterthought, he asked me if I needed anyway refills. I said, no, but I'd need Lunesta in a month. Then said buttt the Provigil isn't really working much anymore (true, I've slept 12 hours a day for the past week and had class the other 12). He asked, was that for fatigue or ADD? (hehehe, yeah weird that he asks me, but our abnormal relationship works well for me, since I have control). I told him both. He then asked if I had tried Concerta, and I said no, so said we'd try that.
This actually was not a previously planned strategy. But, somehow, these words came out of my mouth as the appointment played out. I knew I was very comfortable telling him my current medication wasn't effective. I also knew he thought Concerta was a good alternative. I'm soo lucky that this somehow happened, because I hate bringing up ADHD, and he wasn't picking up on that as a problem to fix.
So now I have my script... 30x18mg tabs...18 mg for 5 days, 36 mg til it runs out, then call see if I can continue (if I hadn't already stopped, which he knows is definitely a concern for me, who's sensitive and doesn't pop pills just because the doc says so), and further dosage. I took one today, and have no side effects. I'm mildly aware of its presence. I think I could do very well on a high Concerta once my body adjusts. It feels "clean". All and all... a very successful appointment. I got exactly what I wanted, medication-wise.
I also got the guidance, caring, motivation, and inspiration to stick out the semester. I reveal so much more of myself every time I see him, it's unbelievable how much our relationship has evolved in the last 6 months. I'm now an open wound, but actually, he has a way of making it feel good, not awkward or too-revealing.
Sorry Dr. Bob, I know you want us to redirect actual conversations elsewhere, I just really wanted to share my story along with the update, which could have been summarized in one sentence. This previously terribly distraught person has turned into one with hope, and wants to share it with others:)
Posted by Phillipa on November 22, 2006, at 22:26:57
In reply to Re: I need advice by tomorrow morning! Update:), posted by jealibeanz on November 22, 2006, at 21:57:45
Thats wonderful. You knew what the right thing for you to do was and you did it and it was more than successful. Love Phillipa
Posted by jealibeanz on November 23, 2006, at 13:38:51
In reply to Re: I need advice by tomorrow morning! Update:) » jealibeanz, posted by Phillipa on November 22, 2006, at 22:26:57
Yup, every visit is always more successful than I could hope for, and never scarey or uncomfortable. He needs to have me come back monthly, since it's that in between time where I just freak out, and always are very calm and happy when I leave an appointment. He may be catching on.
Posted by Caedmon on November 23, 2006, at 22:31:33
In reply to Re: I need advice by tomorrow morning! Update:), posted by jealibeanz on November 23, 2006, at 13:38:51
Sounds like a good outcome! Keep plugging along, the school stuff will be more manageable with the right drug therapy.
I'd be curious to hear how you respond to Concerta.
I'm just doing the slow Lamictal dosing thing right now.
- Chris
This is the end of the thread.
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