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Feb 15th 2009
I'm fairly sure I have undiagnosed adult attention deficit disorder. (There was a picture of me next to the Wikipedia article.) While I don't particularly mind being scatterbrained, the constant feeling of failure and impending doom is really getting to me.
Before I go get my brain looked at, I think this would be a good place to ask - Did any of you get treated for ADD? What kind of treatment did you go through? How does it feel, creatively, emotionally and such?
Feb 15th 2009
I was diagnosed as having ADD about 7-8 years ago (in my 30s). It's made a VAST difference in my life, my productivity, and my general functional ability. I tried a number of different medications before settling on Concerta. Doesn't make my 'hyper' and it doesn't make me 'flat' emotionally, just takes the 'static' out, if that makes sense, and allows me to seperate and prioritize. Hasn't hampered my creativity in the slightest. Good luck with it!
Feb 16th 2009
One thing to look at is your use of stimulants. Many ADD and ADHD folk use caffeine or nicotine reflexively, having found themselves better on them anecdotally, or even subconsciously. But the dosage is a tricky thing, and developing a habit can lead to more than is useful to your productivity.
There are basically three kinds of ADD treatment: stimulants, atomoxetine(Attentin, Strattera), and other(people have used a lot of weird stuff, like antipsychotics, antidepressants, anti-narcolepsy medication, MDMA, muscle relaxants. Studies are equivocal on some, mildly positive on others, anecdotal evidence abounds)
Stimulants can have negative effects, but generally are pretty positive emotionally, creatively, and so on. But tremors, nausea, appetite loss, sensitivity to other pharma, can be kind of hard to bear. Plus the medication can be expensive, and difficult to come across without a prescription. There's a new dermal patch based on the same active stimulant as Ritalin under the trade name Daytrana which I've heard good things about. They're giving it to kids because dosage is much easier to control, and there's less risk of abuse/missed doses, which can lead to a bad seesaw effect.
Atomoxetine is generally very positive or completely ineffective. I was a patient of the guy who did the first major clinical trials, he said that he was impressed by how few side-issues it had, but that it was expensive for new patients, as you'd need to go on it for two months before finding out if it was going to help at all. I found it useful, but not worth the money. I definitely felt a decrease in creativity while I was on it, with some flattening, but that may have been an invention. I don't have any metric for it.
Other treatments seem to vary wildly. Modafinil is a wonder-drug these days in internet experimental pharma circles, and using it for ADD does make some sense. I haven't seen any studies on it, but that doesn't mean they're not there. MDMA and muscle relaxants obviously aren't legal in the US, but there have been some studies on it in Switzerland(they'll look at anything).
On recreation and lifestyle, avoid MJ like the plague, keep your drinking under control, get exercise, you may want to watch your weight. The usual.
One final note, a surprising thing I read in a psychiatric article on cross-disciplinary health, many people diagnosed with adult attention difficulties or developmental issues actually had eye problems. Make sure your glasses or contacts are up to date. Myopia and astigmatism can sneak up on you over years, and it's pretty hard to focus when everything's just a bit out of focus or you have a mini headache all the time.
Feb 16th 2009
My grandfather and two of my uncles definitely have ADD, and I'm pretty sure my Mom's in on the list too.
I'd say just get looked at, regardless. If you have it, and treatment works for you, it'll be fantastic. I'm on some meds for a stomach condition I have, and it makes all the difference in the world between being able to live a normal, productive life and letting it get the best of me.
Funny story - When I was in 8th grade almost eleven years ago, people thought I had ADD too - but then they made the mistake of putting me on Ritalin, and giving me coffee on top of that, figuring stimulants would do the trick.
Remember Tweak from South Park? Yeah, that was me.
Turns out the symptoms of ADD I was showing - being impatient, not paying attention in class, et cetera - were mostly because I was fed up with being in classes that bored the hell out of me.
Feb 16th 2009
@ outlawpoet -
Why avoid marijuana? What's the biological effect?
Siiiigh. I'm rather textbook ADD, and considering things like depression, tourette's, trichotillomania, and a whole host of assorted OCD things run in my family, I guess it all goes together. Both my mother and myself have opposite reactions to moderate dosages of drugs. Weed makes us both more TERRIBLY talkative, random, visual (ooh, sparkley!), opiates/oids make us energetic (though I suppose that's more likely due to both having our own chronic pain issues), stimulants make us introspective. My mother had been on a prescription of Colonopin (sp?) for 13 years, and when she took herself off of them this past year, she lost 25 pounds in the first month, so hyper she's become. It's hard to have a conversation with her now.
Anti-convulsants and anti-spasmodics and muscle relaxants etc. seem a frustrating way to go, for me. I've been on a number of them for my back, and I never felt I could think more clearly. If anything, my brain was still humming just as fast, and I was even slower and less effective and catching the thoughts as they whizzed by me.
I'd gotten a hold of some Adderol a few years back, and my roommate was amazed and astounded and begged me to get some more. I was clear, coherant, productive, and calm. I could write again.
Unfortunately, I've got back problems and muscle spasms, so the idea of being on so severe a stimulant doesn't appeal to me. I'm trying to be as medication free as possible, though the clarity from Adderol is something I yearn for. I think my compulsion towards Claritin D has less to do about my allergies, and more to do with the pseudoeffedrine effect on my brain, but I'd rather leave it at that and a pot of tea a day, and not be dependant on a stronger perscription.
I've also found that listening to fast paced noisey electronica (nothing with words) helps when I'm trying to concentrate - almost as though it creates a sort of wall of white noise that meets and negates the frazzling pace in my brain. I suppose it psychologically does what stimulants are supposed to do physically?
What about biofeedback? I think that's what my mother had. It looked sort of like a TENS unit, but with one electrode right in the middle of her forehead. She'd strap the thing on, her "brain machine," and zone out in front of the TV: "it's like being stoned without being stoned!"
Is there a connection between having nocturnal sleep patterns and having ADD?
Feb 16th 2009
Cannabis is a very complicated thing, biochemically, as most natural drugs tend to be, it's really a bunch of stuff acting in various ways.
The reason it seems to have an exacerbating effect on attention problems is its depression of Norepinephrine, which plays a big role in concentration. Stimulants increase base levels of it, while Strattera and it's cousins decrease the rate of consumption.
(I've just looked up Modafinil, and it looks like there are some studies showing good affect on ADD, but it was rejected for that indication by the FDA. It would operate similarly, increasing dopamine and norepinephrine in specific areas of the brain, cannabis would seem to tend to complicate that effect, although I don't have any references.)
Biofeedback and other attempts to control environment/brain interaction (your noisy electronica, modifying sleep patterns) could have an effect on the ability to focus, although the mechanism is a little obscure to me. I've seen some studies on biofeedback and meditation increasing dopamine levels nearly at-will in real time, which would tend to smooth things out, assuming they don't rise too high and stay away from the frontal lobes.
My best guess on the fast noise electronica would actually be adrenaline and stress toxins, though. Simulating a low level of excitement and stress without anything specific to latch on to would increase your ability to focus, whether you had ADD or not. It might be worth the experiment to try raising your heart rate quickly (via exercise or fear or something else handy) to see if it increases or decreases the effect.
On nocturnal sleep patterns, I actually did see a correlative survey showing that people with social disorders and attention problems tended to skew later. This might be adaption, people learning that they don't get anything done when there are too many other people around, and so staying up later to get the isolation and focus they need to succeed at tasks and feel comfortable. That's entirely speculation, though. It's a real effect, but I don't know the causal mechanism for certain.
Unfortunately, party-line in the US right now is throw stimulants at ADD. Atomoxetine is pretty much the only non-stimulant alternative, although there may be some good options coming out of trials in the next few years.
Feb 16th 2009
@outlawpoet - while I'll agree with you on the drinking, I do have to disagree on the use of cannabis.
I have an official adult ADD diagnosis, FWIW, obtained as an adult at about age 32, and have been a moderate regular MJ user since college. I also have a philosophy background and some serious doubts about the entire "disorder" hypothesis of ADHD and most "psychiatric disorders", and believe there's a lot of validity to the notion that ADD is socially generated. In any case, there's no doubt that the inability to cope with long-term planning and the resultant anxiety and avoidance mechanisms are damaging to existing in modern society.
I find the use the cannabis works excellently for me in three respects: Reducing distractability, reducing anxiety, and increasing creative productivity. When I'm in an ADD crisis, cognitively I tend to find that I am so focussed on trying to grasp the entire perfect gestalt of a project that pragmatically I'm unable to accomplish the couple of simple next steps I may need to take in order to advance the project, and corresponding anxiety and avoidance behaviors just pile up.
On the other hand, a suitable maintenance dose of cannabis enables me to mentally step back from the situation, and perform the effective list-processing or brainstorming steps I have to take and advance whatever project I'm working on. Falling asleep a little earlier doesn't hurt, either, as often times I wind up just spinning my wheels when staying up late at night trying to work. I find the use of MJ generally enhances my planning ability, brainstorming, list-processing, task assignment, and all of the project-management detail tasks that go with my job. I'm able to think about things in terms of weeks or months; when in the middle of ADD thinking, I have a hard time thinking past the next few hours or immediate crisis.
I've had a few years to evaluate my behavior and some reason to look at and adjust how I'm treating my condition now. I've tried Ritalin and Wellbutrin, which I both found helpful but not effective by themselves. I've been working on getting back into the psydoc for a renewal on the official pharmeceuticals, and probably will try a round of the newer stuff such as Adderall - my doc is pretty open to writing scripts. I'm tempted to go for Provigil as well.
I realize that this is openly pharma shopping, and I'm alright with this. I put my treatment of ADD into the same category as other self-care such as trying to eat well and bathe regularly and am not particularly concerned about utilizing whatever works to manage my cognitive function, whether that happens to be purely cognitive such as therapy or biofeedback, herbal, medicinal, lifestyle changes and so forth. Managing ADD, whether one looks at it as a "real disorder" or as a symptom of modern postindustrial existence, is certainly something that needs to be approached on all levels and as a general problem of lifestyle management that absolutely cannot be just medicated away for maximum effectiveness and especially if you want to take advantage of some of the cognitive styles that it does make available for use.
I found myself nodding at many of your points, especially the inverse reactions to drugs - I have the same reaction to opiates and stimulants. And especially the white noise effect - I also tend to listen to more techno/electronica when I am trying to focus on tasks like web design or scripting that demand intense focus. I also avoid quiet places in general while working, and used to do almost all of my studying in college down at a bar with the jukebox blaring.
Feb 16th 2009
I made an offhand, facetious comment to my mother about having ADD when I was 20, which is something that I think everyone does.
She made me a doctor's appointment, and it turns out I have ADHD, for which I take 30mg of Adderall a day.
At first, I was really nervous about this--I didn't think I was really THAT bad, and I didn't want the drug messing with my creativity or emotions. Fortunately, it hasn't; I've become far more productive, in fact, and it also helps bring me to full alertness in the morning. Plus, as an added bonus, I lost 25 pounds, but that happens, too. After I was diagnosed, I thought it was kind of funny, until the majority of people I know reminded me that I am an absolute spazz and that they are not surprised. My outward and social behavior doesn't seem to change
much when I'm on the drug (although I do get
into what I'm doing sometimes), but my Tweak-esque tendencies when I'm not medicated have become much, much more obvious to me and the people around me, when compared against my medicated behavior.
I give adderall 2 thumbs up. But I'm not on it today, so I'm not sure if that was coherent...
Feb 16th 2009
Gotta say, I don't 'believe' in most ADD diagnoses, as the 'disorder' is worded. Chemical imbalance? Certainly. But I think a lot of it is socially generated.
This is not to discount anyone's experience. And I have symptoms myself. (Hell, there's a great deal wrong with my head. I've had more EEg's than I can count. I did biofeedback for years.)
"Anything that can be treated chemically can be treated non-chemically" slurred a drunken William S Burroughs.
How did people in the past treat ADD? Diet and exercise. Probably the only treatment they had and it probably worked as well as it could.
Feb 16th 2009
@mister hex -
Pretty much agreed - through about 90% of human history, "ADHD" behaviors were survival skills, I'm firmly convinced, and in the same realm of modern problems as obesity.
In a neolithic or gathering culture, the ability to pack on fat from short-term heavy eating and hold it for a long time is a survival trait. Swooping down on that sugary treat like you might never see another? Clearly programmed behavior, as is the fat that it goes straight to your hips. The people with hypermetabolisms that don't retain any fat would have either starved or frozen.
Similarly, "Hey look at that chicken!" is detrimental to modern life, but pretty useful as a hunter, as is the ability to hunker down in hyperconcentration for hours while waiting for an animal or looking for predators. Not very well suited for filing out complicated forms, and likewise the folks with "normal" attention spans who put all their attention into, say, farming are the ones who are going to get carried off by a dire wolf.
So I'm not a genetic determinist either - I look at cognitive style as akin to your physical phenotype, or sight or hearing. They determine your limits and abilities, but you are free to determine how you react and cope with them as well.
Feb 16th 2009
I was diagnosed with ADD in the early 90s when the ritalin craze was ramping up and took ritalin/methylin from 7-23. I feel as though I may have been duped into relying on it and so I kicked it upon graduating from college.
I am of two minds about the whole thing. On the one hand I hate having to rely on drugs to get things done (says the ex-pothead alcoholic) but on the other I can't really function well without it. I fall into deep depressions, can't motivate myself to do anything, have extreme social anxiety and difficulty articulating what I am thinking and gain weight. As soon as I am back on it I am creative, focused, motivated and on top of my game again. My only while ON the drug is that I find it hard to get drunk progressively, which leads me to drink a lot and then suddenly become totally wasted out of the blue which, as you might imagine, is not the greatest, especially for a regularly gigging musician.
The thing that bothers me about this is that I had no say in whether or not I wanted to be treated at such a young age, nor did I have any concept of the ramifications. Would I have developed the ability to focus on my own had I not been relying on the drug while still in my developmental stages? There's no way to know I suppose but I think about it a lot. I was hoping that getting it all out of my system would help, but all it did was create a big mess in almost every area of my life.
I have friends and relatives who have started using it later on in life and found it extremely effective. My father, for one, takes one occasionally and says it really helps him buckle down and focus. In college kids who had to study for tests would take some to focus, almost every time the kids would complain about not being able to focus at all and feeling jittery and sick so I have seen both sides.
@rachelnoel I also find that the fastpaced noisy music helps. Also extremely repetitive music like Godspeed You! Black Emperor is something I find extremely helpful. I suppose it is kindof like a wall to the outside world, drowning out distraction. But it is almost more than that, I found that when I was working on my thesis if I listened to these really repetitive post-rock songs I wasn't even tempted to check my email or read blogs or anything, just focus. I wonder why that is.
Feb 16th 2009
I was diagnosed with ADD in 3rd grade, but responded poorly to the pills and we didn't attempt any alternatives when I stopped taking them. Now, as an adult, I'm reading Edward Hallowell's ADD books and treat it with diet and exercise. Besides 20-45 minutes of aerobic exercise, I also use a wii fit every day - the balance games and yoga in particular seem to help increase my focus and coordination. I'm also avoiding even minor stimulants like caffeine lately, much to my own dismay, because as I've gotten older their effects have gotten stronger, less controllable, and a lot less fun.
As for how it feels - I hate being forgetful, distractable, and clumsy, but the visceral creativity the condition seems to facilitate makes me glad to have it despite the drawbacks. I believe that using medication to treat it would make me a worse artist. Everyone responds differently to meds, though, and they could work very well for other people.
Rachael - I need a near-constant influx of music, any music (well, it does have to be good). The Kills have been my go-to band for working lately. And I don't know if it's related, but I certainly have nocturnal sleep patterns. ADD also, in my experience, seems to either make people more likely to be hedonists or is at least more visible in the personality type. Now there's a positive side-effect!
edit: Oh, yes, I would also like to say that without timers and post-it notes, my forgetfulness would literally have caused my house to burn down by now. I store my short term memory outside my head.
Feb 16th 2009
Hallowell wrote the classic intro to ADD back in the 90s. His stuff is generally pretty good. He's also one of the psychiatrists who, like some in this thread, object to the disease model of mental health. The general objection is the organizing mental traits and issues into disorders and pathologies can both lead to improper grouping of symptoms and traits(as there aren't single underlying causes like germs in most mental disorders) and that it's stigmatizing and polarizing.
I have some sympathy for this opinion, but I haven't seen a positive proposal to replace it. DSM-IV-TR is a massive thing, collecting reams of useful data and science, and connecting therapies with a very wide array of issues. Something to replace it would need to be more useful, and just as broad. That would require either a similar massive amount of work, or some new organizing taxonomy or theory to compress the useful data. I mean, DSM-V won't be out until 2012, conservatively, and they've been working on it since 2000.
A long time spent in drug therapy can definitely lead to a decreased ability to function without it. There are a fair amount of research going right now about guided procedures to help people get off psychiatric medication (particularly antidepressants and antipsychotics because they're so powerful) while minimizing the chemical instability and long term effects going off and on them have.
If you want to get off stimulant ADD treatment without going off the rails, and you can find a psychiatrist willing to help, there is some research on using monoamine reuptake inhibitors to compensate for a long term stimulant user's reduced production. The dosages are generally adaptive, and transient, hopefully trending to no drugs at all, in conjunction with other therapies for managing ADD traits. It sounds like a fairly intensive and long term procedure, and a good doctor and a lot of motivation would be a must.
Feb 16th 2009
Regarding the Marijauna...
I must say, that while I DO get more talkative and energetic, I have similar positive expereinces as those described by Stygmata. On a sober daily basis, I get so... worked up I end up reving in high gear standing completely still. I sit at the computer, planning out every step of my day, the order in which I should do something, and end up doing nothing but wandering from room to room, unshowered, in my pajamas and find six hours have passed and I've done nothing but drink coffee. And yet, I'm stressed. I FEEL like I've been busy frantic, but I've done nothing. Not even shower.
When stoned, I find a get the sort of hyper focus I used to get as a small child when I'd lose myself in a book and not hear someone speaking to me just a few feet away. I'm still easily distracted, but I can see detail when I concentrate.
I suppose I could describe it like.... if ADD is looking at Saturn's racing rings from Earth, each thought being tiny rock spinning by, leaving nothing but a motion blur.... while stimulants like Adderol give my consciousness a high-tech, miles fast, floating space observatory that matches the general speed of the orbiting chunks of rock; allows me to see more than just a million streaks of motion in one giant incomprehensible flat ring of illusion...... then marijuana is a massively powerful telescope that sits on the moon. Like from the space station, it's easier to see when not clouded by earth's atmosphere, but while the telescope only slightly and sometimes turns in the direction of orbiting ring-bits, slowing the percieved speed of whiz-by, the telescope gives such emmense magnification, such severe zoom, that even though I get but a flash, a split second still image, I can see each space rock with the kind of hyper-detail that burns the image in my brain. (and sing to myself while it goes on :D )
Between the focus, the chronic pain, and isolation-depression, I'd be a pothead if not for the fact that it worsens my vision and therefore makes me less productive. Regarding the suggestion to raise my heart rate and see if that improves my ability to mentally focus - it might, but physical exhersion seems to worsen my ability to VISUALLY focus. Ah, it's all be easier if my eyes worked right.
Regarding Mister Hex's point...
that's rather part of why I try to stay away from psycho-pharmecuticals. It rather worries me to take drugs for something that's largely untangible. If there were a litmus test for the various chemicals in my brain, how my receptors recieved them, and how a given drug affected these activities and levels, I'd be far less wary. It's like basing all of pain management on the "How much do you hurt, from 1to 9?" scale without bothering to define the underlying disorder. Yeah, sure, if someone is screaming in pain and can't even speak coherantly due to thier severe agony, yeah, give them a morhpine shot.... but too many kids are given fentanyl patches for a sore throat.
( i see this thread going on in long rambling back and forths, with many of them ending with "did what I write just make sence?"... heh.)
Feb 16th 2009
Something to keep in mind--
Activities like concentration, discipline, self control and attention span are skills that people have to learn, practice, and spend a lifetime mastering. While some medication may help with people on the outlying arms of the bell curve, I am very skeptical of the demand for medication. I believe what most people need to understand is that they have a deficient skill set, and with training those skills can be brought up to par. Unfortunately, our society gave up on teaching those skills about thirty years ago.
I many ways, drug use harms our ability to learn these skills. All my pothead buddies started as teenagers, as awkward teenagers who suffered lots of anxiety. Because pots so good at removing anxiety, they kept using well into their twenties and thirties. A few of my friends have noticed that when they stop, they get massive anxiety attacks. What I think is happening is the fact they've never learned how to handle anxiety. Just like sitting on your ass in front of a computer in your bathrobe will not let you develop killer pecs and real ultimate power, no matter how many times you read that website.
On the other hand, there are many, many people who have taken a focused medical approach and come out aces, so there is that. I'm ambivalent, until I see statistics of therapy vs. medication vs. both.
May 18th 2011
@ Rachæl Tyrell:
Two things: Loved your Saturn's Rings analogy, very accurate. I came up with a shaken snow globe metaphor for my old shrink; each speck of snow is a thought, feeling or whatever's going through my mind at any given time - visible for a split second before being swept away by the blizzard of other things before I can properly focus on it or any of the others. If I wasn't so easily distracted, it'd be even more frustrating than it is.
The other thing which caught my interest was you mentioning stimulant ADD meds possibly exacerbating back problems. I've got facet joint degeneration in my lower back and the idea of a psyche medication adversely affecting it hadn't crossed my mind. Definitely something to discuss with my doctor if/when they ever move beyond the pre-assessment assessment (not kidding) I had six months ago. God bless the good, old NHS.
(If anyone's still reading this thread, it'd be interesting to hear how everyone who originally posted back in 2009 has been doing since then.)
May 18th 2011
Mr. Hex is once again right on point here. ADD is not a disorder so much as an invention. We all have ADD, its called being human. Look around at the society we live in, how many advertisments do you see on your way to work in the morning? Society has created this environment so that its fictional disorders can sprout legs so that, in turn, it can make more commercials for more pills no one really needs.
It is my firm belief everyone has ADD. To what degree and what is the right way to treat it are important questions, don't get me wrong. But be careful about what you put into your body and for what reasons... the Man has eyes, and he's watching you.
May 18th 2011
I'll add another vote to the recommendations of Edward Hallowell's books. No scare tactics, no magic cures, just a lot of facts and various things to try.
I was diagnosed in my early 40s. Let's leave aside all the drama and trauma that got us to the diagnosis, but simply say it was pretty disasterous. Once we'd decided ADD was a probable factor, we had to pick a treatment. Improvements would be nice, but I'd managed to make it through 40 years of the condition and didn't want to do anything that might significantly change my personality. Since the coping strategies had already broken down, mild drug therapy was the next choice. Ultimately I wound up on a fairly low dosage of Adderol, which continues to this day. We have tried a few other things, but they either didn't help or changed me in ways neither my wife nor I liked.
Conversely, one has to be careful not to let ADD be an excuse for anything. I'm responsible for getting my job done, taking care of wife and kids, and so forth. ADD makes that somewhat harder, but doesn't relieve me of the responsibility for my life. When ADD makes something difficult, I have to back up and come at it in a different way. So far, so good.
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