Slashdot Mirror
Working with ADHD?
Famanoran asks: "I've recently been diagnosed ADHD ? and am now taking Ritalin. I've found that it helps me rather significantly, but I'm keen to try other things that may help. My question is to the ADHD'ers on slashdot: How have you coped with ADHD, and how have you found it affect your work performance? Do you object to having ADHD? Have you tried natural alternatives such as DPA/EPA (Omega3), 5-HTP (natural precursor to serotonin), and what were your results? Also - How do you find it working in groups of people, either as the only ADHD'er there, or in a group of ADHD'ers? Do you think that your ADHD contributes to your abilities technically, or is it a hinderance?" Previously, Ask Slashdot dealt with ADHD in children, now what suggestion do you have for the grown-ups, with the additional burden of a career, who find themselves in the same situation?
I haven't really had a problem with ADHD, even though I get distracted easily sometimes. I think coffee seems to help a lot, though that's just me. I never took ritalin, but I was on Adderall for a while (it's similar to ritalin, though not quite the same). I really disliked taking it though, because I felt really odd, lost my appetite and had frequent headaches. I honestly think that it's hyped to be a larger problem than it really is.
Tell the doctor you want Wellbutrin - it works better and has far fewer side effects.
It varies by person, as everyone has a different body chemistry. You might find yourself with uncontrollable shaking, cold sweats, loss of balance, and a number of annoying side effects if it doesn't work for you. (It didn't for me)
A. Either (1) or (2)
(1) six (or more) of the following symptoms of INATTENTION have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
Inattention:
(a) often fails to give close attention to details or makes careless mistakes in schoolwork, work or other activities
(b) often has difficulty sustaining attention in tasks or play activities
(c) often does not seem to listen when spoken to directly
(d) often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
(e) often has difficulty organizing tasks and activities
(f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
(g) often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
(h) is often easily distracted by extraneous stimuli
(i) is often forgetful in daily activities
(2) six (or more) of the following symptoms of HYPERACTIVITY-IMPULSIVITY have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
Hyperactivity
(a) often fidgets with hands or feet or squirms in seat
(b) often leaves seat in classroom or in other situations in which remaining seated is expected
(c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
(d) often has difficulty playing or engaging in leisure activities quietly
(e) is often "on the go" or often acts if "driven by a motor"
(f) often talks excessively
Impulsivity:
(g) often blurts out answers before questions have been completed
(h) often has difficulty awaiting turn
(i) often interrupts or intrudes on others (e.g., butts into conversations or games)
B. Some hyperatice-impulsive or inattentive symptoms that caused impairement were present before age 7 years.
C. Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).
D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.
E. The symptoms do note occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder)
When I was first diagnosed with ADD (ADHD minus the hyperactive aspect) and put on Adderall, I was amazed to discover that it really was possible to follow the thread of an entire meeting and sit down for hours doing work that didn't absolutely fascinate me.
Adderall is a mix of four amphetamines used to combat Attention Deficit Disorder and Narcolepsy. It was originally prescribed to the obese as a hunger suppressant under a different name. I originally started on 3 doses per day of Adderall. That was problematic, however, because I would become more forgetful as it wore off, meaning that I needed to remember to take my next dose when I was at my most forgetful. I now take the extended-release version called Adderall XR. I only take it once a day, and it's helped enormously.
I've only been medicated for a couple of years now, so I've noticed a stark difference in my ability to function normally. Life before I was diagnosed was filled with frustration. I sometimes found it incredibly difficult to concentrate even on things that I enjoyed doing, or that I really wanted to do. My homework grades were terrible but my test scores tended to be quite good. Now, with a combination of medication and an intentional reduction of potential distractions, I can work steadily all day if I need to.
There are drawbacks, however. It completely obliterates my appetite. I find that if I don't make an effort to eat 3 square meals a day, I will forget to eat at all. Not being one who needs to lose weight, it caused some problems in the beginning. I won't feel hungry, but I'll get very cranky, headachy, and will find it difficult to focus when I don't eat.
I also find that I can be a little cranky in the late afternoon when I'm coming off the medication. ADD medications like Ritalin and Adderall are highly addictive, which really sucks. After taking Adderall for a couple of years now, I find that I have the attention span of a gnat on cocaine if I forget to take it.
Do I object to having ADD? Sometimes. But when channeled correctly, it's a really amazing source of creative material. It can also be quite entertaining to my friends. I'm just really glad I'm just really glad I have some control of it now.
Attention Deficit Disorder is hard for many people to understand. I've had people tell me to my face that ADD is a sham and that I'm just lazy. Fortunately, it's not a topic that comes up often.
Unfortunately, I don't know much about these alternative treatments, but I'm certainly interested in learning more.
The problem with the amphetamines is that being a schedule II drug it is had to find the doctor who is not hesitant at prescribing such, also you have at the start have a doctor appointment to have it refilled, after such you can probably get the doc just to write it where you can stop by and pick it up. Adderall - XR is adderall's time release based medication which can be negated by the crushing or chewing of capsules.
It would be my preference to go with Adderall-XR as doctors see it as a less abuse able substance, and I've found it to be the best in increasing concentration and productivity, in a side note it offers a perk in euphoria, for those in a down mood and Iâ(TM)ve found Ritalin in different accounts to be "rough" on the system
For fun from the prescribing PDF on Adderall Alkalinizing agentsâ"Gastrointestinal alkalinizing agents (sodium bicarbonate, etc.) increase absorption of Amphetamines. Co-administration of ADDERALL XRâ and gastrointestinal alkalinizing agents, such as antacids, should be avoided. Urinary alkalinizing agents (acetazolamide, some thiazides) increase the concentration of the non-ionized species of the amphetamine molecule, thereby decreasing urinary excretion. Both groups of agents increase blood levels and therefore potentiate the actions of amphetamines. TIME (HOURS)
Also in the view of amphetamines it is nothing like those found on the street and sadly so as the meth found will undoubtedly bring you up, it seem to lack the focus of the combination of the amphetamines offered by Adderall. For those looking to the street for their fix Iâ(TM)d urge you to give up the expensive and non productive habit, Sleepless nights and worn out bodies, and talk yourself into some disease.
Ritalin is the most popular. It is used mostly for treating children. Its generic form is methylphenidate or MPH. Studies have shown that MPH is up to 30% less effective than the brand name drug, Ritalin. It can cause tics in children. Those who take Ritalin do not develop tics. Ritalin begins to work within 20 minutes after you take it, and lasts up to 4 hours. An extended-release form of Ritalin, Ritalin SR, has been developed, but how long the drug lasts still varies among individuals. Class action lawsuits against the manufacturer of Ritalin, Novartis, have been dismissed in Texas and California. In both cases, the judges found that the plaintiffs had not shown sufficient evidence that Novartis conspired with psychiatrists to "overprescribe" Ritalin.
Dexedrine is second most common to Ritalin in use for treating ADD. It is used mostly for treating adolescents and adults. The generic form of Dexedrine, dextroamphetamine sulfate, is considered inferior to the name brand, and not as long-lasting. Dexedrine begins to work 30 minutes after you take it, and lasts about an hour longer than Ritalin. Dexedrine is listed in the PDR (Physician's Desk Reference) under "diet control" drugs; thus your insurance company may not cover it for treating ADD.
Cylert is the third most common stimulant for treating ADD. The generic name of Cylert is pemoline, but no generic drug is available. Cylert begins to work an hour after you take it, and you must take the medication for 1-2 weeks before you feel the full therapeutic effect. You should not skip doses, or go off Cylert "cold turkey". Dosages are must be gradually increased and decreased by your doctor. Cylert is more expensive than Ritalin or Dexedrine, and has a higher incidence of side-effects, such as insomnia and appetite suppression. There is also a possibility of liver damage.
Adderall, formerly Obetrol, is a newer stimulant, approved by the FDA in 1996. There is no generic. Adderall is a combination of Dextroamphetamine and Amphetamine; its
I felt a personal need to reply to this posting, as it mentions many things I have tweaked within the last six months. Throughout my life, most of my symptoms persisted of bouts of hyperactivity per day including super-human concentration, followed by huge crashes and lapses of concentration, and the complete ability to think, with extreme anxiety thrown into the equation. Just within the last year have I fully noticed the mood swings, and how low I could get in the winter months, being in Canada around Toronto area -- similar in geographic location to Detroit and Buffalo.
1998 - added the minor things, like multi-vitamin, extra B vitamins, vitamin C, vitamin E, ginkgo biloba, this was about 4 years ago, and these additions just barely helped me cope. Sleep was still a great issue, with it normally taking two hours to go to sleep at night
1999 - added melatonin to the mix, nightly took 3mg, switched jobs, quit working at a systems integrator (tech work, systems and network support on the road) to join a chain of long-term care homes as their regional technical support
Fall 2001 - started seeing a "naturopath", drastically changed diet, followed "Blood Type Diet", recommended from the book "Eat Right for Your Type", amazing results, super high energy (probably a manic episode), but still the anxiety and sleeping issues persisted, added Alpha Lipoic Acid to assist the liver and as a potent antioxidant
Winter 2001 - added 5-HTP, fairly high doses, around 500mg per day
Spring 2002 - cut down on the 5-HTP, limited it to 200mg per day, added Piracetam, thinking clearer than ever
March 2002 - went to a corporate conference, ate all of those sweets and stuff that they give you that weren't on my diet, experienced the worst brain fog in my life, saw my chiropractor the next day for an adjustment, got in a conversation about feeling "fogged out", he suggested CLA, amazing results, eliminated the fog!
Summer 2002 - cut down 5-HTP to 150mg per day, added L-Tyrosine to the mix, it gave me more of my personality back, strongly recommended over stimulants, as it helps long-term even after cessation of usage
Fall 2002 - blood type diet slips really hard, the 5 pints a day are getting in the way of it. . . at this point, not taking any 5-HTP or melatonin, flying really high, going out all of the time, getting 4 - 6 hours sleep per night, have never thought clearer in my life. Started further extensive reading on 5-HTP, Tyrosine, mood disorders, ADD / ADHD, bipolar, etc., had inklings I was cyclothymic, a mild version of bipolar disorder
December 2002 - had been going downhill for the last bit of November, honestly thought there was a more serious problem, anxiety flared up again, saw a doctor, started on Paxil at 10mg per day, zapped all of the life out of me, dropped it down to 5mg per day, ceased taking 5-HTP due to concerns of potential serotinin syndrome or overload with SSRI
Christmas 2002 - crashed out completely, nasty family Christmas sucked all of the life out of me, I had been going downhill for the month of December
Mid January 2003 - Paxil was not performing for the depression, I had since stopped taking anything to change mood, such as Tyrosine, 5-HTP, started on 750mg per day of Depakote/Epival, took a real edge off, minimized long-term mood swings and mood / energy level changes in the day
February 2003 - the first doctor didn't agree I should be on Paxil, as it didn't address the attention symptoms, so he cut it out, and added Effexor SR in it's place, an SSNRI (Selective Serotonin Norepinephrine Reuptake Inhibitor) at 37.5 per day for a week, and then 75mg for three weeks
Late February 2003 - feeling so flatlined it's not even funny, no desire for anything remotely social, have been at home now for two weeks straight not moving off the couch, getting up only when desperately needed for work, not returning any phone messages, voice mail box full!
March 2003 - recontinued the Paxil at 5mg, much more personality back, sold my house, moved back in with my parents (lovely...
/If you can find one person with it who actually thought school was fun but couldnt concentrate in class, well then I'll believe you. /
Me. I've just been diagnosed with ADHD, and I loved school. Hell, I loved school so much I did pretty well, and ended up at MIT...and before you say I liked high school with ADHD because I managed to do really well (unlike most high school students with ADHD) then I'd point out I'm having a ridiculously hard time with MIT...but I still love it there.
So there. It's not a "lazy gene", nor necessarily even a disability. It's just a different way of absorbing information.
-amysarah
But the real problem with ADD is often how it interferes with normal life. You leave the house to mail a letter or a bill and end up in a bookstore a couple of hours later without the letter and unable to remember if it was actually mailed, or if it is sitting on a bookshelf someplace.
This is not a matter of people being lazy and your statement that it is shows how little you know or care about other people. My physics degree is proof enough that I am not lazy. Nor do I consider myself to be inferior to others. And I don't get any special benefits or privileges, despite your belief that I am somehow being coddled by the rest of society.
A little while ago a fellow named "MichaelCrawford" posted a three part article on Kuro5hin describing his experiences with Schizoaffective Disorder. Some of the symptoms he desribed and some of the lengthes he went to treat them were similer to yours. Anyway here's that article. I hope you find that helpful.
"The moment "pride" is lost, "freedom" is also lost." - Ramza.
I am. I also happen to be an expert on the central catecholamine systems, which are implicated involved in ADD.
I really, really didn't want to be drawn into this debate because, like religion and politics, you are often either preaching to the choir or a wall.
However, your utter misinterpration of the dopaminergic system, along with the completely fallacious claim that many people have made regarding lack of scientific evidence is egregious.
ADD is real, and it's a problem of the brain. Its etiology is not completely understood, but better understood everyday. Is it over-diagnosed? Probably. Is Ritalin over-prescribed? Probably. However, the boundary between what is and is not ADD is fuzzy, and a difference of degree, not quality.
First, quick factual rectification: Increasing dopamine in the front of the brain does not slow the brain. In the front of the brain (prefrontal cortex), increased dopamine is thought to help keep focus on current task demands by sharpening their representations in attractor networks of neurons. That is to say, the front of the brain keeps "online" what it is you intend to do right now. If this "goal" or "intention" fades or is disrupted by competing intentions, you get off track and distracted. In ADD patients, this is thought to happen too readily. Increasing dopamine levels (via agonists like ritalin) is thought to help lock down intentions and goals, keeping them "online" and the person "focused."
However, the majority of your post is a kind of armchair philosophizing about the place of ADD in the spectrum of psychiatric disorders. Unfortunately, convincing the general public of the reality of psychiatric illness and the utlity of psychoactive medications is a problem of paradigm. People, including you, are far and away dualists even when they claim not to be. And I use dualism here in an extended sense, to appy to psychology as it does to to metaphysics. People tend to be adamant that there is a distinction between the mind and the brain. People tend to think there are a class of "real" organic disorders of the brain, and then there a bunch of fluffy dysfunctions of the "mind" which are due to socialization, personality, will, judgment, and possibly genetics (although they don't see the contradiction of this last one).
Here's the truth: You are your brain, your brain is you. The brain gives wholly rise to the mind, and the mind is wholly derived from the function of the brain. One is a phenomenological construct, the other is the implementing hardware.
Here's another truth: The brain is plastic and every moment of experience changes it. Now, all organs changes and adapt, but no other organ is designed to be as profoundly plastic as the brain.
The first point invalidates the idea that some psychological problems are just "in people's heads" while others are "chemical imbalances." Every feature of a person's behavior is rooted in the brain. Some breakdowns in brain function have a gross, systematic nature that makes them easier to categorize (schizophrenia, parkinsons, alzheimer's, etc.). While some, like ADD are a little subtler. And some, like personality disorders, are subtler still and chronic. Generally, the more the disorder impacts the way the brain conveys personality, social interaction, or sense of "self" the more we believe the problem to be relegated to the artificial realm of "mind" not body.
The second point underscores the fact that both chemical and experiential treatment of the brain have real impact. By chemical, I mean psychopharmacology. By experiential, I mean things like psychotherapy, self-therapy, social interaction, changing the environment. All these things affect a person's mind and hence their brain (or vice versa).
Anyway, back to science: Here's a good reference on the scientific basis of ADD. Its a little dated, but it's by the same group that performed the neuroimaging study some AC linked to earlier (http://www.nimh.nih.gov/events/pradhd.htm ).