Is there a pill for this?
July 12, 2013 2:54 PM   Subscribe

I seem to have the patience, judgment and self-control of a two-year-old. Nothing against two-year-olds, I'm sure many of them are lovely people, but little is expected of them beyond not biting people. I've mastered the not-biting part, it's the rest I have a problem with.

I feel that some part of me has never "grown up"--I seem to be unable to talk down my needy, howling inner toddler who makes way more of my decisions than is sane or reasonable.

Some examples:
I am really bad at coping with things if I'm the slightest bit stressed or tired--which happens a lot, despite my efforts to protect myself. EVERYTHING seems to stress me out. Strangers, traffic, work, socializing--if it takes place outside of my home, and/or involves novelty of any kind, it's almost guaranteed to leave me feeling jangled.

I have a terrible work ethic, particularly (but not limited to) when I don't care about my job and/or don't have a fire roaring under my ass. How on earth do other people sit at their computers all day and do actual work!? My brain reels at the sheer tedium of it. Every moment of the day is a struggle not to surf the internet instead of doing actual work. (And before you suggest it, I can't install any kind of block on my work computer.) My job makes me feel furtive and lazy, and terrified that I'll get fired. As merely going into work eight hours a day seems to sap all of my energy, I have none left over to look for a better job--and frankly, I sure as hell wouldn't hire me!

I'm messy and disorganized. I can never seem to get on top of the piles of stuff around the house and the list of things that needed to get done yesterday.

I have no self-control around sweets or booze, which leads to Problems.

I'm really damn clumsy and seem to take liberties with the way things like gravity work. For instance, it always seems like a great idea to balance a giant pan of hot, freshly cooked spaghetti on the corner of the sink while I search for the colander, until it tips over onto the floor.

In conversation, I have a tendency to blurt out inappropriate or embarrassing remarks. I deal with this by clamming up and not saying anything.

I find socializing even with close friends to be generally overstimulating and exhausting. Once a month is about all I can handle.

I can be moody. This is the thing I'm least proud of. If I'm stressed or overanxious or feel that I am "failing," particularly in a social setting, I shut down. I lose the ability to even pretend to still be interested in what's going on around me. If I'm extremely stressed, I've been known to pick fights with my loved ones. Rationally, I know that I should just chill the fuck out, go home and get a good night's sleep or whatever, but that voice of reason is completely swamped by the enraged two-year-old in my head who insists that this situation SUCKS and somebody has to ANSWER FOR IT! After picking fights or creating drama or whatever, I feel exhausted and completely mortified by my behavior.

Having said all that, does anyone have any thoughts on what steps I might take to get a handle on this? Since I know it will come up, I will say that I have long known that I have ADHD, but have been advised against taking stimulants because of my anxiety problems. In fact, my therapist warned me that she's had clients with anxiety disorders who had actual psychotic breakdowns when taking stimulant meds. I did try the non-stimulant meds and hated them--Wellbutrin especially made me into an aggressive talking machine and it was really quite unpleasant.

Is there anything else I can try? Any way to placate the grumpy little monster in my head who haughtily turns down any efforts at doing better by yelling "NO! I don't WANNA!" As easy and lazy as it is to defer to this voice, I would really like to grow up sometime soon, if only so I can start to develop a little self-respect.
posted by anonymous to Health & Fitness (10 answers total) 39 users marked this as a favorite
I have ADHD, along with anxiety and depression issues.

The drug combo I'm on is: 50 mg of Lamictal along with my 18 MG of Concerta. I only need very little of each medication to be functional. Yes, I've had the breakdowns when only on stimulants. But, also in my case, there were depression issues behind it, and I've had the same type of breakdowns when not on anything at all for my mental health. (By 'breakdown', I should say that they've been the 'crying for no reason getting a coffee' breakdown. Not full blown psychosis).
posted by spinifex23 at 3:02 PM on July 12, 2013

Is there anything else I can try?

Cognitive behavioral therapy.

posted by Sys Rq at 3:35 PM on July 12, 2013

Man I can't wait to read answers because this sounds a lot like me but I don't really like to drink. I am thinking the answer is going to be "therapy" because that's what happens here, but maybe mindfulness meditation? I haven't tried it myself because it sounds so corny, but maybe you can check it out and report back!
posted by masquesoporfavor at 3:54 PM on July 12, 2013 [1 favorite]

IANAD, nothing at all actually, except pretty anxious and a little depressed for most of my life.

If you've tried all the non-stimulant meds and hated them, you've surely also tried Effexor (Venlafaxin)? It is an antidepressant also prescribed against generalized anxiety and social phobia. I got it for depression, but for the past three months I have been living an anxiety-free life. Oh, and according to the internets it's also been used for ADHD.

If I'm extremely stressed, I've been known to pick fights with my loved ones. Rationally, I know that I should just chill the fuck out, go home and get a good night's sleep or whatever, but that voice of reason is completely swamped by the enraged two-year-old in my head who insists that this situation SUCKS and somebody has to ANSWER FOR IT! After picking fights or creating drama or whatever, I feel exhausted and completely mortified by my behavior.

I used to be like this too, and it went away with age and self-awareness. It wasn't easy, but I got there with no meds. Did you know have the freedom to WALK AWAY from stuff that stresses you out? That was a huge discovery for me and I started leaving when I felt stressed out. You can also tell people you can't deal with them right now, because you need a time out. You're too upset. This was good for my relationship with my loved ones, not so good for new stressful and/or exciting situations and people.

I actually went to the psychiatrist complaining I felt, like you, so stressed out about every single little thing people do, including friends and acquaintances at social events, but especially strangers I had to deal with at work and just basically the little annoyances in life. They made me so angry it was impossible to deal with them "normally". I also felt incapable of finding interesting things about many people in my social circle and got very bored in conversations.

Three months into the pills, I still prefer my people to be not dumb, boring, lazy or annoying. The only difference is it doesn't upset me the way it did. I don't feel like I fail in social situations, and I used to feel this keenly. I just don't feel like I need to be interested in everyone any more, so I don't feel like every conversation has to be a "success" or every party the best one ever. It's the kind of thing that only really matters under the microscope of anxiety, in my experience.
posted by in girum at 4:00 PM on July 12, 2013 [2 favorites]

Aww, you've said a lot of really not nice things about yourself up there and it makes me sad to read.

Are you talking about all of these things you mention with your therapist? I'm not a therapist and so this is just my personal opinion here, but it seems like all of the examples you shared have a common theme in that you don't feel worthy. And I mean worthy as in the sense of that sweet spot of seeing the value in something and having trust in it. That something in this case would be yourself.

It sounds like you don't trust your judgment (being around temptations, being able to say things without monitoring/filtering), your abilities (working, keeping house clean) or your coping mechanisms (how you handle things when you're stressed, tired, or said something that caused you embarrassment). That last one is its own special treat, as it kicks you when you're already down. And perhaps you don't value your reactions to things (your body and mind telling you when a situation sucks, is stressful or is simply not fun). Or valuing your body/self/mind in general.

When I was in my 20s, I was at my most anxious and my most clumsy. I had a friend who would often get really angry with me when I would drop things, bump things, break things. Granted, that wasn't a healthy reaction on her part, and it upset me. I didn't understand her reaction and it took me a while to learn why she was having it.* I felt like clumsiness was a personality quirk at best or possibly a deficiency (bad spatial skills) at worst. What I didn't realize was that it was me not paying attention to my limbs, body, space and movement. I didn't pay much attention because I didn't really care. I didn't care because I didn't see the value in it, in me, in my body. Once I started noticing, treating myself kindly and really putting energy into better self-care all around, that's when things started to change. Instead of viewing things that went wrong (falling pots and nights out where I'd done or said things I regretted) as failures on my part, I started seeing them as signals of something needed. My feelings and reactions (stress, moodiness and the tireds) weren't things that should be dealt with so much as they were helpful warning flags telling me to go lie down, go for a walk, go do something nice for myself.

What if when you were tired, you went and rested? Stressed or anxious, you left or exercised or found some other release? What if you spent more time doing kind things for yourself? For the benefit of nobody else but yourself. There is meaning and purpose to that. It sounds like in many ways, you're screaming for it. And screaming at yourself for it. For needing it. You're worthy of everything you need, especially what you need to be happy. Find small ways to be kinder to yourself, your mind, your body. Self-care is totally where it's at.

Sending you a big hug and a wish for lots of happy, stress-free peaceful times spent doing things that make you happy.

*She didn't like seeing me being so oblivious to myself and so unaware of what was going on around me, what I was doing. Partly because she cared about me and wanted to see me do well, but also partly because me lack of attention had a damage radius that she was in (ex. bumping her or breaking her things...hell, even walking down the street with me was annoying).
posted by iamkimiam at 4:10 PM on July 12, 2013 [11 favorites]

Hi there, Me!

I have some of your habits at work and have tend to be unfocused. I was able to find a new job that has more structure and pre-set goals, while still having some autonomy. That's just something that helped me.

Be well.
posted by michellenoel at 5:13 PM on July 12, 2013 [1 favorite]

Acceptance and Commitment Therapy 'fixed' it for me. Well, a combo of that, mindfulness and realising that I was fucking up my life by forcing myself into these situations.

So, as an example, through therapy and group therapy and stuff, I realised 'quiet' is a Value I have, right? Sounds dumb as shit though - who the fuck does that? Well, me for starters. And every time I try to work against that value - go to parties, work in loud environments, go to noisy restaurants - I ramp up my anxiety threefold for the situation, how shit I am as a person, and how shit everyone else is. So now I accept that I like the quiet and when I'm stressed I need quiet. So I can work with it. And I stopped beating myself up about it because it's okay, that's just how I am. Just like I'm fine with people who need to be noisy, or twitch, or talk it out. I can accept that, so why beat up on myself? And that one small thing has made an enormous difference to my life, my family's life. It's made my ability to deal with other stuff better, and made me a happier person in general. All for the sake of things not being loud. And I'm not a bad person for liking quietness! It's okay to ask friends and family to talk instead of shouting, or go outside to play yelling games. It's okay not to have three competing forms of noise on at once. I'm okay!

Between that, and the rest of therapy, I don't flail as much. We don't have the exact same issues, but your unkindness to yourself and your needs is heart-breakingly familiar.
posted by geek anachronism at 5:14 PM on July 12, 2013 [9 favorites]

So I don't know exactly what anxiety disorder you have, and it may well be that stimulants are contraindicated for you. But just as an n=1 data point, I have generalized anxiety disorder and ADHD. I take Pristiq for the anxiety and Adderall for the ADHD, and the Adderall does not make my anxiety worse. It actually makes it better, both for the obvious reason that when I can focus and handle my life, I have less to panic about -- and because it helps me stay focused in the present, which keeps my brain from spiraling off into the endless worry-ruminating thoughts.

If you've just had the one therapist tell you not to take stimulants -- especially if your therapist isn't an MD -- then I might advise you to seek a second opinion. Because everything you're describing here is absolutely textbook ADHD, and stimulant meds can be really helpful in controlling it.

However, whether you can take meds or not, I'd still recommend finding some cognitive-behavioral therapy, from a therapist who's experienced at working with ADHD. Cognitive-behavioral therapy teaches practical strategies for changing your behavior -- and for retraining your thoughts. It was really helpful to me for anxiety, as well as for ADHD.
posted by snowmentality at 5:35 PM on July 12, 2013

I have anxiety, for which I take a middling dose of Escitalopram nightly, and my psychiatrist didn't blink at giving stimulants a try when we determined I had ADHD, inattentive type. Which, by the way, manifests in me in SO MANY of the ways you describe, especially the clumsiness, balancing food in weird places, general disorganization, and self-control issues. I feel you on those so hard.

I'd get a second opinion from a psychiatrist, especially if like others have mentioned, your current therapist is not an MD. I think there is definitely reason to exercise caution in taking stimulants side by side with anxiety, but it seems like your current therapist is overgeneralizing and might not be up on current practices for ADHD and anxiety. On my ADD meds, I can do things like wash the dishes, remember to feed my cats at the same time every day, finish my course readings, and put my clothes away in a place where I'll find them later. Even though the meds are stimulants, I feel less anxiety because I'm better able to cope with the day-to-day.
posted by augustimagination at 6:24 PM on July 12, 2013

I have anxiety and I take stimulants for ADHD.

Stimulants actually seem to improve my anxiety, because not being able to focus or follow through the way I want to makes my anxiety worse.

I don't know anything about your anxiety, but maybe a second opinion would be a good idea.
posted by bunderful at 6:30 PM on July 12, 2013

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