asperger's vs. adult add?

June 18, 2005 9:53 PM

I have always had attention problems, but when I was tested in 1993, the tests came back inconclusive: the neuropsychologist concluded that only 7% of my 'issues' was ADD. That was twelve years ago. In my adulthood, I'm having serious problems concentrating, but am unsure of the effects the common ADD medications will have on me, and I'm curious if there are different treatments for attention deficit due to adult ADD and due to other 'issues'.

Other information: I'm heavily self-medicated with stimulants, most notably caffeine. I've tried to cut back, but I still consume at least 36 ounces of caffinated sodas per day. (I don't like coffee, it tastes like mud mixed with Fat Bastard's toilet leavings to me.) When I, noting the health effects of consuming that many empty calories per day, cut caffinated sodas out of my diet, my life and my business started to fall apart. Having experimented with caffeine as a stimulant over the past year, (cutting it out of my diet and adding it back in), I'm finding that I require it to focus enough to accomplish anything in a day. It's not the sugar; drinking decaf but sugared sodas has no effect on me.

Commonly available psychoactives and OTC drugs (exotic alcohols like asbinthe, marijuana, claritin etc.) can have extremely unintended effects on me. Claritin, for instance, will make me extremely depressed for three days after one dose. Marijuana will make me extremely paranoid. We're not going to discuss what asbinthe did to me the one time I tried it. I've completely stopped experimenting with drugs and am extremely hesitant to take *anything*, even presecribed ('cept antibiotics), lest it unbalance me in some strange way. I've always overcome psychological or behavioural issues with a focus on self-discipline and 'self-counseling sessions', but this seems to be unsurmountable.

My experimentations with caffeine have lead me to the conclusion that I need a stimulant for my particular brain chemistry to avoid the 'ooh, shiney!' effect. I do have a long history with an undiagnosed learning disability that involved several processing disorders and a small degree of ADD when I was tested for it in the early 90's (before the asperger's diagnosis made it into the psychologist's version of the physician's desk guide, or was really even heard of); the symptoms and childhood behaviour led my mother to one day email me a scan of the list of Asperger's symptoms from one of her education trade magazines (we're not talking Newsweek here) with each line checked off in red magic marker... and then another list of adult aspergers' symptoms, which also almost precisely matched me.

Having had long experience with my particular HMO, Kaiser Permanente, I know that I need to go in with a clearly defined set of problems and researched potential resolutions to get anywhere. My mental health coverage is minimal, so I'd like help doing research in advance while avoiding the trap of self-diagnosis (Which, yes, I realize I've mostly fallen into. Bear with me...). If I don't go in with that clearly defined set of issue and resolutions, they'll milk me until my coverage runs out and I have to start paying out of pocket for mental health office visits.

How can I focus my requests to the mental health professionals at my HMO in order to get some sort of treatment for my inability to focus or maintain personal discipline without a chemical stimulant, or are there other resources I can seek out to help figure out why my brain needs to be fueled by caffine to get anything requiring focus completed?
Also, does anyone have any stories they'd like to chip in about overcoming psychological or behavioural problems that might help me overcome this issue, with or without medication?

posted by SpecialK to health & fitness (9 comments total)

I actually took a computer test that measured attention, but this was almost 10 years after taking medication. It confirmed my original self-diagnosis.

I really, really like concerta, a sustained-release amphetamine, but I was developing a facial twitch thing, which could have been due to stress and sinus pain, but I quit taking it a week ago to see what happened. The concerta was the most effective of dexedrine, ritalin, wellbutrin, imipramine, and a few others. YMMV.
posted by mecran01 at 10:24 PM on June 18, 2005

Try fatty acid supplements, in particular, EPA.
posted by Gyan at 3:03 AM on June 19, 2005

Regular rigorous exercise is supposed to have some effect too (usually attributed to the resulting increased blood flow to the brain). Don't go by what you read on the internets for drug effects/effectiveness, though--much like antidepressants, finding out which stimulant is right for you is mostly a matter of trial and error and highly individual.
posted by availablelight at 5:32 AM on June 19, 2005

Also--unless you can trace the attention/concentration problem back to your kindergarten years or earlier (an "official" ADD/ADHD diagnosis involves a detailed personal history, examining school records, calling relatives that knew you when), it could be stress, thyroid issues, sleep issues, temperment, LD, just plain aging, etc. (I don't know anything about Asperger's so can't speak to any overlap in symptoms, studies on comorbidity, etc. If you have a friend who has PubMed access.... )

I'd also advise you (if you haven't already) to check out the (several) lengthy threads on AskMe on this whole issue just in the past 18 months or so.
posted by availablelight at 5:39 AM on June 19, 2005

You might want to look at consulting a dietician (and a proper one not just one in the local health food store, although they can be quite knowledgable). You'd be surprised at how much diet effects your brain chemistry I know I had a terrible time comming off caffine when I'd been diagnosed with IBS.

I know removing wheat from my diet had some pretty radical effects on my energy levels, one thing a dietician may suggest is to try removing various types of food from your diet and see how that effects your attention span and energy levels.

Oh when I need a wake-up I use a coffee subsititute made from Guarana it's called 'Wake-cup' a health food shop probably can point you in the direction of something similar.
posted by invisible_al at 6:30 AM on June 19, 2005

Can't give any recommendation for the HMO but caffeine is a pretty mild drug for most people and if it works for you I'd stay with it. It sounds like you just have problems with the delivery of the caffeine being linked to calories. Caffeine is available in pill form most every where as an anti sleep aid. Watch the dosage when you first start the pills are mostly aimed at people who can't consume enough coffee to stay awake while driving 36hrs straight.
posted by Mitheral at 7:05 AM on June 19, 2005

I think exploring anxiety's role in this situation might help. The length and complexity of your question suggests that you're quite analytical and devote a great deal of thought to things. These are good qualities, but it can be taken too far. If the mind is too preoccupied with internal dialogs, it's very hard to focus. There's also a possibility that your atypical reactions to various intoxicants is not so much a chemical difference as it is them exposing unpleasant emotions you're unknowingly carrying around. Stimulants can help as they compensate for the mental fatigue induced by overactive thoughts.

This may not apply to your situation, but it's a variable worth considering. There may very well still be a chemical imbalance that needs to be addressed, but it can't hurt to see if some of the problem is just background noise easily reduced with cognitive intervention.
posted by yorick at 2:06 PM on June 19, 2005

If you try caffeine in tablets, I recommend Vivarin as superior to Nodoz. Myself, I love coffee.

A friend went on ritalin (around age 25), and loves it. We are very similar. But we also had success with self-medication with coffee and cannabis. The cannabis is to be taken in doses that party folks would consider too little.
posted by Goofyy at 10:09 PM on June 19, 2005

Wow, thanks for all the advice.

I was lucky enough to learn the positive effects of exercise for myself at an early age. I used to rock climb two to three times a week until I hurt my hands ... I now play league sports like a madman, and am always part of one indoor soccer league and one 'fun' league like kickball or dodgeball.

It's been amazing (to me) since I let myself back on the caffeine. In the past few days, I've cooked, cleaned up my apartment (which has been a mess since I restricted my caffeine intake two months ago) and have caught up with some tax paperwork that was too far behind.
posted by SpecialK at 1:22 AM on June 20, 2005