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ADD, Depression, and You!
December 3, 2010 4:48 PM   Subscribe

How does someone know if a stimulant medication (adderall) is helping them the way it was intended to for ADD, or if they are searching for a reason to continue a substance that makes them feel good (aka addictive behaviors)? Where is the line between a "need for functioning" and "it makes me feel better therefore I function better"? Don't most people function better on a stimulant? (also some ethical questions inside about working in the mental health industry...)

Snowflake background:
This article on gifted children with ADD describes my childhood to a T.
http://www.addvance.com/help/parents/gifted_child.html

I remember report cards with the words "absent minded professor" written on the comment section. However, I also remember what in hindsight was probably a full blown panic attack in 5th grade the night before a project was due, because I had procrastinated until the point where I was certain I could not finish it and would fail.
(and the world would've ended... obvi.)

I "coasted" through highschool because I was ahead of my peers for the most part, yet I almost fell apart in college. Luckily, I scraped through, until senior year where I effed up so completely that I had to withdraw from a course and graduate the following year.

I am now about to graduate from an MSW program, one which was HELL to get through.
Any and all ability I had to force myself through writing papers and doing the dog-and-pony show of academia is gone, and I only mustered through because of my decent writing skills (when I finally can produce), my above-average class contributions and discussions (not trying to be vain, just honest), and my crying jags in professors' offices.
I finally (FINALLY) went to seek professional help last year. I eventually agreed to try anti-depressants, and well... I'm still working on things.

I have an extreme reluctance to label myself as someone who might suffer from depression. My therapist said that I am a very good "talking head", and that I intellectualize my emotions.
Going through what was essentially "therapy school" has been a two year long process of analyzing myself in every textbook and every case study. I feel like I can argue every side of my own problem and come up with rationalizations for both being depressed and not being depressed, for having diagnosable ADD or being a drughound.

I don't want to be able to cheat the system; I feel this sort of inflated ego that no one is going to be able to outsmart my brain and ability to trick myself.

Here's what I know and feel like is not stuff that I am deluding myself with:

I was prescribed wellbutrin, and last year I didn't feel like it made much difference. I felt that maybe my depressive tendencies were situational, and that I felt better because that situation (aka semester) was over.

Maybe, 5-6 months into the medication I had some issues, missed multiple therapy sessions without advance warning, got embarrassed, and never went back. (I know. I know.)
Read up online, saw that it wasn't overly dangerous, and quit wellbutrin cold turkey.

Rinse, repeat this current year. Had a horrible semester, decided at the peak of terribleness to take the left over wellbutrin I had. Immediately, I felt better and noticed a difference. This was last month. Last month was/is the first time that I might accept that I actually might have some problem and that I'm not just lazy.

Interspersed a couple times within the last 2 years, I took some adderall from a friend. I had done adderall in undergrad, and I enjoyed it. (though I never used it recreationally, I only used it for all-nighters)
When I took the adderall this year, I felt so much better. I wasn't so freaked out anymore, I felt confident I could finish my assignment. I felt calm and my mood was cautiously happy. My immediate thoughts were, "I want to feel like this all the time."

I stopped taking my leftover wellbutrin today, and I don't really want to continue it. I feel that when I'm on it I have more headaches than normal and some jaw clenching that borders on painful. ...I also can't drink while I take it. And more so than I feel comfortable admitting, that's a pretty big factor in why I don't want to continue. I can however continue to obtain adderall from this friend, and I am sorely attempted to simply medicate myself.
I am afraid to go to a psychiatrist and say all this for fear of being dismissed and being labeled a drug seeker (and because I still have that ego trip that I'll be able to convince him/her of whatever I choose regardless of reality), AND YET as someone who has been effing trained in mental health, I realize that none of this is particularly good for me and that it's pretty clear I have issues that should be taken up again.

I also feel that in addition to that mess, I have the additional drama of being someone who eventually wants to work as a social worker and potentially deal with substance abusers. (I already do in field placement.) How can I ethically work while self-medicating on the side?

Sigh. Any and all comments/advice appreciated.

throwaway email: ADDed.DramaRama@gmail.com
posted by anonymous to Health & Fitness (30 answers total) 22 users marked this as a favorite
 
How can I ethically work while self-medicating on the side?

How can you ethically work as a social worker while illegally taking a controlled substance? You . . . can't. Have you read Edward Hallowell's books on adult ADHD? They're a place to start--and the Hallowell Centers might give you some good referrals for psych practitioners.
posted by liketitanic at 4:56 PM on December 3, 2010 [5 favorites]


Non-ADHDers may get more done over any given short term while on stimulants, but they tend to not be calm. The calming effect you describe is why it's prescribed to ADHDers -- it's working for you.

Go get yourself a real diagnosis, speak honestly with your doctor, and, if your doctor considers it appropriate, get a prescription. The drama here is optional.
posted by Zed at 5:06 PM on December 3, 2010 [6 favorites]


You can tell your doctor how you felt while on the Adderall and let him/her help you decide whether that's a therapy that can actually help you. It seems as though you're worried you don't know whether you actually need the medication or hey, maybe it just feels great and you don't deserve to feel that way if you don't have ADD. Well, tell the doc, "Hey doc, I feel better/calm/normal/functioning/adjective when I take this stuff, but I am worried that I am tricking myself into thinking I need it because it feels good to take it."

The more you can be HONEST with your doctor, the more they can help you figure out what's going on.
posted by eldiem at 5:14 PM on December 3, 2010


This is why you should consult with a psychiatrist and continue to go regularly to one. Stop diagnosing yourself and remind yourself you aren't a medical professional, you're a social worker. You should talk to a licensed medical professional who understands the pharmacology of it and not strangers on the internet.

You really can't "feel" your way through this question to a right answer.
posted by anniecat at 5:20 PM on December 3, 2010 [4 favorites]


I want you to repeat Zed's last line to yourself until it absolutely registers: 'the drama here is optional.'

Drama is stimulating. And 'rewarding,' honestly. I have severe ADHD. Whether you have that ir not, you do seem to be cycling through internal drama and getting stuck in it and thinking about it, so I advise you that when you're in situations like this, to default to making the boring and least exciting choices to resolve situations. Like therapy. And honesty with your therapist and medical providers. I am in no way being sarcastic.
posted by Uniformitarianism Now! at 5:26 PM on December 3, 2010 [3 favorites]


Non-ADHDers may get more done over any given short term while on stimulants, but they tend to not be calm

This is a function of dose, not ADHD or not. It's quite possible for an average person to find a dose of amphetamine which will provide some of the benefits the OP talks about while not giving them the jitters and such.

OP: You are raising some very interesting and difficult questions. I've thought about the line you mention, between a "need for functioning" and "it makes me feel better therefore I function better". I'm actually leaning towards the conclusion that there often isn't a line and that in many cases there is no moral or ethical difference. There are practical differences, sure, but that's not what you're asking.

But self-medicating with speed you get from a friend is on the other side of one of those lines. Whether one considers it crossing an ethical line or a practical one is not really relevant. But it is very much not a good idea.

My immediate thoughts were, "I want to feel like this all the time."

Well, this is another one of those problematic questions. It's the kind of thought you would expect from someone with chronic pain who finally finds an effective and safe pain killer. But it's also the reason heroin and such is so alluring. So, again, I'm forced to conclude that this isn't a moral question but a practical one. And again I have to conclude that continual self-medication with a serious controlled substance you get from a friend is on the far side of an important practical line.
posted by Justinian at 5:47 PM on December 3, 2010 [3 favorites]


You cannot ethically work as a mental health provider while using illegally procured medications.

Get a prescription for the medication that makes you feel like you're functioning better from an actual doctor.

You know that this is the right thing to do, but you're trying to beanplate yourself out of it because you're afraid.
posted by Sidhedevil at 5:48 PM on December 3, 2010 [3 favorites]


Tip: Being smart does not make you better qualified than your therapist to either diagnose or treat you. Start over with a therapist whose professional credentials you trust, tell them everything from Wellbutrin to ADD, and go from there. You do not sound like someone who is coping well to me and I suspect you could really benefit from the help.

Then make a list of everything you know about why being compliant with meds is good for patients, post it on your fridge, and get it through your head that you are not an exception to that rule.
posted by DarlingBri at 5:58 PM on December 3, 2010 [4 favorites]


OK, similarly to DarlingBri, my read on what you've described is that there's a lot more going on for you than "should I take ADD meds or not?" -- getting back into therapy is a good goal.

It is 100% your responsibility to NOT abuse an illegally-obtained substance while you're in a position of providing mental health services to others. I mean, let's even set aside the basic ethical principle of not knowingly compromising the level of care you provide by abusing substances while advising others on substance abuse, and look at this from a completely you-centric point of view: once you're out of your training program and actually have to register toward licensure or whatever the procedure is in your state, you can certainly lose that license if the regulating board finds out about illegal Adderall (what if you decide you want to go work for your county's Child Protective Services or whatever, and, surprise, they choose to drug test their employees?). This is really irresponsible because Adderall is already dangerous to take without regulation from a doctor anyway, but from the professional standpoint, totally not acceptable.
posted by so_gracefully at 6:12 PM on December 3, 2010 [3 favorites]


"I feel like I can argue every side of my own problem and come up with rationalizations for both being depressed and not being depressed, for having diagnosable ADD or being a drughound. ... (and because I still have that ego trip that I'll be able to convince him/her of whatever I choose regardless of reality)"

Do you have a good relationship with your family? Or a couple of close friends who know you really well? Because it's easy to rationalize while in your own head, but people who know you well, who live with or lived with you, who have your best interests at heart -- it will be VERY CLEAR to them if you're doing better on medication, whatever that medication may be. They can help you sort out whether this is a therapy that's helping you, or whether you're drug-seeking and bouncing from drama to drama (now with drugs!). Because there are things about yourself that are more clear to others than to you, and your attitudes that you're "too smart" for psychiatry makes it even more difficult to think clearly about your own problems.

BTW, it's a little messed up to want to go into social work while, essentially, not believing in psychiatry generally. Either you think you're way better than your clients, who are so dumb that therapy can help them but you're so smart it doesn't work on you! Or you're going into a field that you think is useless bunk entirely. Neither one seems like a healthy professional attitude.
posted by Eyebrows McGee at 7:11 PM on December 3, 2010 [1 favorite]


Are you getting enough sleep at regular hours, enough exercise, eating healthy food, and not having much caffeine? I know these are basic questions you've probably been asked a lot but honestly. Be well rested, get decent exercise and it often calms the mind and you can focus. Sit at a desk all day, drink lots of coffee, stay up late because you're procrastinating, and don't get any physical exercise: the mind sort of goes in circles, anxious tendencies get a lot worse, and you get nothing done except worrying. That's been my experience. I just don't function well in the environment of college and graduate school: very little structure, odd class hours, papers to write that you can overthink to infinity so that they expand to fill all your free time.

Luckily, after I got my degree, I could go work in an office from 9-5 where there is not really a problem of no set schedule, and there are no research papers! Maybe you think things are worse than they really are? You're about to graduate. Once you graduate, you won't have to do the stuff you're doing right now that is making you miserable; you can go work in the field, and instead of agonizing over writing papers, you can be working with patients. Maybe the actual work environment will be good for you and you won't feel like you have ADD. Maybe the problem is that grad school is often just a sucky environment that makes quite a lot of people anxious and depressed. Writing papers makes me incredibly anxious and depressed. So I don't do it any more. Tons of people procrastinate, stress, pull all-nighters, etc. over schoolwork. Why? Because schoolwork sucks! We're just being human imo.

It doesn't sound like you're in a very good place at all right now, but if you're still finishing school and not really having a stable environment and regular job.. once you have a stable environment, it can make a world of difference. Take a few months off to relax and do nothing if you need to, or at least try to simplify to do as few extra things as possible. And it sounds like you are taking this or that drug to bring on a good enough mood so that you can get your work done? I'd rethink that - being in a good mood is not a necessary precondition for getting work done.
posted by citron at 7:28 PM on December 3, 2010 [2 favorites]


For what it's worth, my SO would say exactly the same thing you did about Adderall in reference to Effexor. She takes it because it makes her feel better. What other reason would there be for taking any psychoactive drug?

That's not to say you should be obtaining it illicitly; you need to see a good psychiatrist. Preferably one who can refer you to whatever sort of therapist that may help you with your "thinking" problems.
posted by wierdo at 7:36 PM on December 3, 2010 [1 favorite]


I went through similar thoughts when I tried adderall to get some schoolwork done. I felt great. It was like this fog had just been sliced off of my brain and the sun was shining for the first time in 15 years.

Adderall will make depression symptoms disappear. However, it is not prescribed for depression for a good reason: it is addictive and you will develop a tolerance to it. It's not something you can use long-term to make yourself feel better without serious repercussions. Just because a drug is legal and available does not make it perfectly safe.
posted by girih knot at 8:06 PM on December 3, 2010


I don't know the specifics of how you store the Adderall you get from your friend but here is something to consider:

If you are carrying it around on your person you are holding a controlled substance for which you have no prescription. Laws vary by state, but it would be a misdemeanor in NY and a conviction for Criminal Posession of a Controlled Substance, 7th degree = trouble for you with the state licensing board. You would also be in the unenviable position of being a Social Worker who had to explain to prospective employers why you were convicted.

As to how you could possibly be caught: Car accident with serious enough injury that the police collected your belongings for you and discovered the pills or a blood test subsequent to the accident that revealed the presence of a stimulant in your bloodstream or lost purse/bag turned over to the police are just two examples off the top of my head.

These may be remote possibilities but you still should consider how you are going to explain being on/having in your possession a controlled substance stimulant for which you have no prescription.
posted by mlis at 8:12 PM on December 3, 2010


I think most of us who are diagnosed with ADD as adults feel some guilt about relying on medication, after toughing through without it for so many years.

Look, just go get yourself a proper diagnosis and prescription and find a therapist. Because that will get you to a place where you can think clearly, explore these issues in therapy, and consider sustainable longer-term plans for how to manage your depression and ADD.
posted by desuetude at 9:16 PM on December 3, 2010 [2 favorites]


Adderall will make depression symptoms disappear. However, it is not prescribed for depression for a good reason: it is addictive and you will develop a tolerance to it. It's not something you can use long-term to make yourself feel better without serious repercussions. Just because a drug is legal and available does not make it perfectly safe.

But to clarify: the fun speedy effects of amphetamine do wear off and to get that same fun speedy feeling, you do need to increase the dosage more and more.

But the therapeutic effects for true ADHD sufferers are still there. I was diagnosed with ADHD as an adult, and was terrified that I would "like" the Adderall and turn into a speed freak.

But that didn't happen. I never really felt any of the effects of it at all. Only once did I ever feel speedy, and that was one day after a dose change. About 3 hours after taking the pill I got sort of a headrush like the top of my head was going to blow off.

But even though I don't "feel" it, th positive effects are there. I can fill out forms without spacing out, I can complete tasks in one or two tries, rather than the 6 it used to take.

It does feel like a veil has lifted. People without ADHD don't have that veil, or it only shows up when they are tired or otherwise fatigued. They CAN push through and make it work. People with ADHD can't.

Serious stuff: even though the effects are the same, the ethical ramifications are completely different depending on how you obtained the drug. You gotta get a prescription, or you gotta quit taking it. Also, your question/post reads as really speedy and disjointed. Something isn't right. Either you are taking it and you shouldn't be, or you aren't and should. Either way, you need to get back to a doctor and get it straightened out.
posted by gjc at 12:19 AM on December 4, 2010 [2 favorites]


Stop diagnosing yourself and remind yourself you aren't a medical professional, you're a social worker.

Even medical professionals aren't supposed to treat themselves, or even family members - you lack the distance to make good judgments. This applies very much to self-medication - you're not just making a judgment about a condition, you're also making a judgment about the risks and benefits of a treatment.

This is without getting into the legality and ethics of the issue - as a medical student we have particular teaching on the ethics of treating your family, the issues around doctors and addiction. I don't know the situation with social workers, but controlled substance use, even if you claim it as 'self medication' will potentially get you thrown out of the profession.

I'm also going to echo another comment upthread on why you want to work in mental health - from your post you obviously have a strong belief that admitting mental health problems is a massive sign of weakness/failure, that taking treatment rather than toughing it out is another sign of weakness. This sort of attitude could well communicate to your clients, even if you attempt for it not to - and if even your social worker thinks you're weak and a failure, that's a terrible message in the middle of mental health problems. There are lots of other fields for a MSW to work in.
posted by Coobeastie at 2:02 AM on December 4, 2010 [1 favorite]


See a good psychologist for the ADHD diagnosis. A thorough assessment should take a couple of visits. Seriously --- there's more to it than checking off symptoms in the DSM.

You'll respect a good assessment and if you are diagnosed, you won't feel like a fraud anymore--or like you talked your way into getting meds.

Then you can work with someone on the meds.
posted by vitabellosi at 2:31 AM on December 4, 2010


I have to echo what others have said. What you have written expresses some worrying actions and attitudes. The way you have written it suggests that your mental state is off. Supposing the problem is not ADHD or substance abuse, but something else? In that case, Adderall could be having a disastrous effect on you.

I don't know if you have ADHD or not. Only a professional can tell you that, as someone in your position is supposed to know. I really shouldn't have to point out that you need to get properly diagnosed and be truthful to your doctor - you should know this already. I shouldn't have to point out that Adderall is dangerous if misused - you should know this already. The attitudes you have expressed about diagnosis and treatment are either disingenuous or ignorant, and even if you stopped misusing Adderall tomorrow, I still would not see you as someone who should even consider working in mental health or with substance abusers.

What was all that therapy supposed to be for? You seem to have used it mainly as a way to construct rhetorical arguments as a distraction from the truth about yourself. Your memail address says it all: you are writing a script for a drama which might make an entertaining movie-of-the-week but would play out with you and your clients as the victims. But you - and your clients, if you ever have them - are real, not characters in your imagination. It matters what happens to them, and to you.

I think you should print your question and take it to a doctor specializing in ADHD. They will know how to get you the real help you need.
posted by tel3path at 3:44 AM on December 4, 2010 [1 favorite]


I read that webpage you posted, and I was surprised to discover that I was also a gifted child with ADHD. I have thought about taking drugs to help me with my homework (I am in a master's program studying Industrial Organizational Psychology) but was always too afraid of something bad happening.

I don't know if in your program you studied Behavioral Psychology at all. If you have not, then you may consider looking into the behavioral perspective.

Behaviorism says that ADHD is not an illness. You are not sick. You do not have brain damage. There is nothing wrong with you. Rather, “ADHD” is what society labels people who have not learned some specific skills, like time management, how to focus on a task, or how to not procrastinate important duties.

Personally, I find this perspective liberating. I hope you do as well :)

Because of this, then, from the Behavioral perspective, the answer to your ethical question is: no, it is not ethical to take drugs to solve your problems.

If you are interested, I might suggest http://behaviorismandmentalhealth.com as a resource, particularly this post about depression.

I hope that you feel better! I know how crappy depression and etc. can be.
posted by rebent at 7:30 AM on December 4, 2010


'Rather, “ADHD” is what society labels people who have not learned some specific skills, like time management, how to focus on a task, or how to not procrastinate important duties.'

I have learned all these things. I learned them before my diagnosis. I still have ADHD, take drugs to solve my problems, and am doing so ethically.
posted by tel3path at 7:51 AM on December 4, 2010 [2 favorites]


Tell3path, I’m sorry – I didn’t mean to criticize or make light of anyone who is suffering from any sorts of problems at all. I’m only trying to offer a perspective. If you (or the O.P.) don’t feel like pursuing that perspective, then I don’t want to force it on you. But, if I’m able to help in any way and keep my mouth shut, then I wouldn’t be a very good person.

So please don’t take this the wrong way – I’d like to explain the perspective that has helped me overcome the problems in my life, but I don’t mean to say that what anyone else is doing is wrong or bad or stupid or anything like that. Everyone has to find their own path, and I believe that “if it works for you, it works. Period.”

Anyway, it is my opinion that Behaviorism would say the following:

1) Just knowing about “all these things” doesn’t help. Learning how to change the way you live your life is difficult and time intensive and requires a lot of effort. Which, ironically, people with ADHD are bad at. (This is probably the primary problem I am trying to reconcile right now. I don’t know how to solve this, except by the following: it’s up to those people who can help their friends to do so, because you can’t change yourself. (see my previous point about keeping my mouth shut.))

2) Drugs change the way your brain works. Does this “solve the problem”? That’s a question for ethicists, philosophers, religious people, and politicians. In my personal opinion, (and, I believe, in the behavioral part line) the answer is no. However, I don’t think that giving someone drugs is some sort of illusionary placebo that doesn’t actually do anything.

3) Labeling is dangerous, because once a person has a label, it’s all too easy to view all life events through that label. It is possible to self-label. It is possible for doctors (or, more commonly, elementary teachers) to label children who do not have ADHD with the label. I don’t think anyone would disagree that when this happens, it’s a problem. The point I am trying to make is that we should carefully analyze every instance of labeling for accuracy, regardless of whether ADHD is true or false.

4) There is a common misconception that Behaviorism shifts the blame from the source to the victim. For instance, “You don’t have ADHD, you’re just lazy” or “you don’t have a disobedient child, you’re just a bad parent” or “your student doesn’t have a learning disorder, you’re just a bad teacher.” The thing is, behaviorism shifts the blame alllllll the way back to the big bang, e.g. “you are the way you are because of the way your parents raised you, which is because of the way their parents raised them, which is because of how life was during World War II, etc etc etc”
posted by rebent at 8:25 AM on December 4, 2010


Woooah..... on review, I guess I misunderstood your comment, Tell3path. Shoot. Um, I could argue this topic with you, but it's not really purusant to the OP's question, so I won't do that here.

Anyway, I'm sorry for misreading your comment. I thought you meant that you learned that that's the behavioral perspective, and that's what I meant in my item 1.
posted by rebent at 8:36 AM on December 4, 2010


Yeah, if rebent would like to...I don't know, come undo the brain hemorrhage I had as an infant, and prevent multiple cardiac arrests and anoxia, that'd be great. If only I could think differently about their 'realness.'

Seriously, as someone with disorders that range from 'always considered real' to 'oh, look, it's time for the strict behaviorists to tell the truth,' the whole 'real'/'not real' debate is a distraction. It's an in-class exercise. The useful focus is on how to ameliorate the life problems that are resulting from the situation.

OP, you are better served by focusing on the immediate problems and tasks at hand. These are the boring choices. The clash of psychological frameworks and theory? Is intellectually exciting and involving and doesn't address your practical everyday problems or choosing not to obtain medications illegally.
posted by Uniformitarianism Now! at 8:42 AM on December 4, 2010 [4 favorites]


Look, if the illegally procured medication 'works' for you, go through the motions and get it legally by seeing a psychiatrist. You avoid the stigma of scoring illegal drugs, and you don't have to worry about legal issues concerning the usage and possession.

I wouldn't run myself in circles pondering the ethical side of taking amphetamines. Back in the day, I recall visiting a psychologist who would urge me to try and take anti-depressants/speed. He would even talk about how he gets a script to help him through the difficult times during the years. Living better through chemistry and all that jazz. Even professionals take drugs, that doesn't exclude any group (legal, and illegal drugs), just from being in a professional field, you would want to limit any liability from the usage of such drugs, so go the proper channels to obtain them.

So I tried the whole anti-depressants and had nothing but hell until I finally said enough is enough. Switched to a psychiatrist, and was able to get the help I needed through some tough talk therapy. Didn't like him at the time, didn't like the issues we addressed, but it was bar none, the most effective sessions I've ever had in my life and it truly helped me.

From a perspective of someone who does take stimulants (not prescribed to me) from time to time, I wouldn't fret. I know this could be an internal justification on my part, but people take drugs. Its not a character flaw, its not some thing to beat yourself up over. Hell, over half of the United States is addicted to coffee, which is a stimulant. I know people that have gone through the motions to get a script because they feel the need to be the best (grad/law/med program students) and that speed will help them squeak out that A instead of an A-.

By the way, the effects you feel from amphetamine medication is why its prescribed. Of course it makes you feel good (1950's they were prescribed and referred to as 'mommy's little helpers), and lifts that fog feeling from your mind. It is a psychoactive drug, these are its effects. If you are looking to take these types of medications (dextroamphetamine, adderall, ritalin, ect.) talk to a doctor and go through the right method to obtain them. There are health risks to taking amphetamine medications including heart failure that could be underlying issue that even a therapeutic dose could have a negative implication on your health (i.e. death).
posted by handbanana at 8:58 AM on December 4, 2010


Behaviorism says that ADHD is not an illness. You are not sick. You do not have brain damage. There is nothing wrong with you.

The DSM IV says nothing about people with ADHD having brain damage, or that they're sick, or that something is wrong with them. This is a straw man. Most of the people who work with ADHD are of the opinion that it's something that can be used to a person's advantage, not that someone has brain damage or is sick. Even my psychiatrist sees it more of a condition than a disorder, in the sense that there are ways to live with it that allow for its ability to be a blessing. Like people say, it's a blessing and a curse.

I do urge you, however, to reject those who claim that it's just about you not having learned time management skills like everyone else. The vast majority of us who have ADHD have already made about a million attempts to learn and incorporate those skills, and failed repeatedly, which is why we're different- not that we've never been exposed to how efficient people work. I have these skills myself. Am I good at them? Hell no.

It's not so much that I don't know how to manage time, but when I am in my element I'm really not thinking about it. The only way I've found which works reliably is making myself always worry about it. This caused far too much stress, so now I'm late a lot, miss deadlines, etc. I'm not nearly as stressed, however. Blessing, curse, etc.

Get a real diagnosis. Keep in mind that ADHD is one of those conditions which people tend to think isn't real, and you'll get a lot of the advice like this person's. Truth is, if you can find a way to live your life that works for you and isn't inherently unhealthy, then there's nothing wrong with that, but there's also nothing wrong with seeking treatment. But try not to attach too much morality to following the course of treatment. It's valid and healthy for you to seek the advice of medical professionals if you feel there is a need, even if some people look askance at the diagnosis criteria or the treatment. If it works for you, that's what matters.

It's true that a lot of people with ADHD self-medicate with caffeine and other stimulants, but in your field of work you do need to be above board about any controlled substances. I don't think it's necessary to judge your choices- You could self-medicate with caffeine and nobody would complain, which is a bit contradictory IMO, but it doesn't do you any good to dance around the edges of the problem without confronting it and getting a real diagnosis. Taking someone else's Adderall may actually help you to some degree, but it won't ever be as good as finding out whether that's a good idea for you to be doing therapeutically.
posted by krinklyfig at 9:41 AM on December 4, 2010 [6 favorites]


The thing is, behaviorism shifts the blame alllllll the way back to the big bang, e.g. “you are the way you are because of the way your parents raised you, which is because of the way their parents raised them, which is because of how life was during World War II, etc etc etc”

If the perspective was useful for you, that's cool, but it doesn't make it a universal truth. My grandparents and society have very little to do with my time-management skills, which, by the way, are very, very highly developed. (The trick for me is balancing the meticulous mental energy needed for those skills with the mental energy needed to do the higher conceptual thinking that really makes me tick.)

The OP sounds to be at a crossroads right now, given that the current plan is unethically and guiltily self-medicating. Given that, I'm not sure that the academic argument of behaviorism is going to provide more clarity right now than treatment of a recognized disorder (which is therapy and meds, not just meds.)
posted by desuetude at 10:22 AM on December 4, 2010


"I feel like I can argue every side of my own problem and come up with rationalizations for both being depressed and not being depressed, for having diagnosable ADD or being a drughound. I don't want to be able to cheat the system; I feel this sort of inflated ego that no one is going to be able to outsmart my brain and ability to trick myself. ... I am afraid to go to a psychiatrist and say all this for fear of being dismissed and being labeled a drug seeker (and because I still have that ego trip that I'll be able to convince him/her of whatever I choose regardless of reality)"

This to me says "print out this question and take it to a psychiatrist you really respect." It sounds like you need someone you consider to be no nonsense, not likely to suffer bullshit, and really smart. And then with them you can explore these very questions.

It's clear from your question that you (a) need help and know it, (b) question whether someone can overcome your defenses and actually help you, (c) worry that your desire for help is or may be perceived as something shameful (e.g., drug-seeking). I submit for your consideration that (b) and (c) may be symptoms of some brain chemical thing, or part of the same thought processes that have clearly not worked for you so far. And in any case being up front about them with someone might go a long way toward helping clear them up.

It also sounds like you are surrounding the issue of getting treatment with a fair amount of shame and/or anxiety, and you're responding via avoidance (if I treat myself, it's not real, I didn't officially [seek drugs / deceive anyone / etc.]). A lot of the underlying attitudes here could benefit from therapy and maybe meds, and be worsened by hiding.

Everything you're worried about is twice as bad if you treat yourself, from the question of deception vs. real need (people deceive themselves, too) to external judgment about drug-seeking.

It doesn't sound like your self-medication is really working, from your question, and doing it on your own means getting no external feedback on some of the attitudes and beliefs you're carrying and that aren't helping. Meanwhile, you're suffering. Search for someone whom you can trust to really help.
posted by salvia at 11:05 AM on December 4, 2010 [2 favorites]


Meanwhile, you're suffering. Search for someone whom you can trust to really help.

Yeah. That's what I was going to say. All these terms, diagnoses, " I have ADHD"
, I have this, I have that, self-medication, drug abuse, etc etc

It all seems like your busy busy mind going going going (and running running running). I agree with your therapist there (that you are good at intelletualizing).

None of these diagnoses and categories are that helpful to you at the present time. I would suggest looking for a therapist who can help you start to get more "in touch" with what you're actually feeling.

I also would recommend a book to you: "There Is Nothing Wrong With You" by Cheryl Huber.
posted by DMelanogaster at 10:59 AM on December 5, 2010


Do you feel like Adderall is helpful? It sounds like it. Then go see a psychiatrist and talk about it.

I had the exact same dilemma as you. I felt like I had attentional issues. I started seeing a psychiatrist and told him about these concerns. As I was also dealing with some anxiety issues, he indicated he didn't want to start medication for that until my anxiety was under control.

Then a friend gave me ONE pill of his Adderall. It helped immensely in dealing with things and not overthinking the details of everything I do. It helped me just DO, rather than WORRY about doing. So in that sense it also helps with anxiety!

I went to my psychiatrist and said "I took one pill of a friend's Adderall. Here are the effects that I observed," described how it made me feel, and said, "I would like to take medication." I was then prescribed Dexedrine.

This experience really fits with my past experience (over 10 years ago) with acute depression and anxiety, where I found that most doctors found it HELPFUL for me to tell them what medication had worked for me, even if I had tried it initially without a prescription. When it came to things that I hadn't tried, like anti-depressants, there was a lot of experimentation in finding the right one and the right dose. They seemed to appreciate me coming in and saying "I have found anxiolytic Drug X helpful at this dosage. I understand the risks associated with its use/withdrawal, etc."

On the other hand, my General Practitioner treated me as a drug-seeker. Years ago when I asked for a prescription for Xanax to deal with my anxiety when flying, I was given a talk about drug dependency and a non-refillable prescription for 5 of the smallest dose possible.

But the difference here may be that a GP has 3 minutes to assess you, while a psychiatrist has 45-60 minutes once a week.

I also understand how hard it can be to get over the "I know what I want, but I'm afraid to ask for it" hump of dealing with mental health professionals. If you can look at it as an explanation to them, rather than a justification, that might help.
posted by MonsieurBon at 3:51 PM on December 6, 2010


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