Their way or the highway, meds edition
August 14, 2023 8:05 AM Subscribe
People in relationships where your partner has a mental health issue and you don't (or the other way around, sure) how did you resolve disagreements about treatment strategy?
My partner is unhappy with the way I’m managing my symptoms and often makes my condition (and treatment for it) more about their effects on them than about their effects on me My partner says they can tell when I haven’t yet taken my medication for the day (fair. I can, too.) and also said they can’t live with me if I’m not going to be on stimulants. The lack of empathy is disheartening. The fact that they even contemplated leaving me over it is frightening. My partner lately avoids me, screams at me, and generally makes me feel like I’m unwelcome around them. It’s not great for my mood, nor is it great for my blood pressure.
I’m officially diagnosed with ADHD, inattentive type. Years ago, I was also diagnosed with depression, and I’ve been on medication for that all along. For ADHD, I’ve tried two stimulants, Strattera and Adderall. The Strattera caused a lot of undesirable (to me) side effects, so my doctor switched me to Adderall. That came with its own side effects but nothing like the discomfort I was in while taking Strattera.
I dislike the come-down from Adderall, the elevated blood pressure, and what I’d call the “strung out” effect that only goes away if I take more. My doc is also concerned about my elevated blood pressure and he asked me to monitor it at home for a month before a follow-up. Adderall, being a stimulant, affects blood pressure, and so does Wellbutrin, the depression med I’m on. As an experiment, my doc switched me to an additional 150 mg of Wellbutrin for ADHD on top of the 300 I take for depression. He supports the off-label use of Wellbutrin for ADHD, and I’m curious to try something other than a stimulant considering I know Wellbutrin works for my depression.
I've read up on the effects of someone’s ADHD on a non-ADHD partner. I’ve also read the flip side, the strategies for the non-ADHD partner coping with the ADHD one. I’m sympathetic to my partner’s feeling alone, but lately, I’ve felt alone on this myself and actually antagonized on top of it. My partner’s fear of me being off medication is unfounded. I won’t be off medication. I’ll be off Adderall for at least a while, to see what extra Wellbutrin can do for me instead. I know we’re under the same roof and my partner has a right to be concerned for them, but I feel like the mandate that I need to be on a stimulant or else is going too far.
My partner is unhappy with the way I’m managing my symptoms and often makes my condition (and treatment for it) more about their effects on them than about their effects on me My partner says they can tell when I haven’t yet taken my medication for the day (fair. I can, too.) and also said they can’t live with me if I’m not going to be on stimulants. The lack of empathy is disheartening. The fact that they even contemplated leaving me over it is frightening. My partner lately avoids me, screams at me, and generally makes me feel like I’m unwelcome around them. It’s not great for my mood, nor is it great for my blood pressure.
I’m officially diagnosed with ADHD, inattentive type. Years ago, I was also diagnosed with depression, and I’ve been on medication for that all along. For ADHD, I’ve tried two stimulants, Strattera and Adderall. The Strattera caused a lot of undesirable (to me) side effects, so my doctor switched me to Adderall. That came with its own side effects but nothing like the discomfort I was in while taking Strattera.
I dislike the come-down from Adderall, the elevated blood pressure, and what I’d call the “strung out” effect that only goes away if I take more. My doc is also concerned about my elevated blood pressure and he asked me to monitor it at home for a month before a follow-up. Adderall, being a stimulant, affects blood pressure, and so does Wellbutrin, the depression med I’m on. As an experiment, my doc switched me to an additional 150 mg of Wellbutrin for ADHD on top of the 300 I take for depression. He supports the off-label use of Wellbutrin for ADHD, and I’m curious to try something other than a stimulant considering I know Wellbutrin works for my depression.
I've read up on the effects of someone’s ADHD on a non-ADHD partner. I’ve also read the flip side, the strategies for the non-ADHD partner coping with the ADHD one. I’m sympathetic to my partner’s feeling alone, but lately, I’ve felt alone on this myself and actually antagonized on top of it. My partner’s fear of me being off medication is unfounded. I won’t be off medication. I’ll be off Adderall for at least a while, to see what extra Wellbutrin can do for me instead. I know we’re under the same roof and my partner has a right to be concerned for them, but I feel like the mandate that I need to be on a stimulant or else is going too far.
This isn't a conflict about medication, this is a conflict about compliance. Your partner wants compliance and is punishing you when they don't get it. That's not a good, healthy, or non-abusive way to approach conflict and I would strongly suggest you think about where your line is.
You've done a lot of reading about ADHD - I recommend looking into, or paying attention to, the trauma that people (especially but not limited to women) with ADHD very very often end up with, in which they feel like they are constant fuckups and everything is their fault. A relationship that recapitulates that trauma might feel so natural to you that it doesn't occur to you that it's neither normal nor necessary, but it is in fact not normal and not necessary. You might not be compatible with everyone given the symptoms of your ADHD, but being screamed at, belittled, and ignored is not the price of living with it, regardless of your medication regimen.
posted by restless_nomad at 8:17 AM on August 14, 2023 [40 favorites]
You've done a lot of reading about ADHD - I recommend looking into, or paying attention to, the trauma that people (especially but not limited to women) with ADHD very very often end up with, in which they feel like they are constant fuckups and everything is their fault. A relationship that recapitulates that trauma might feel so natural to you that it doesn't occur to you that it's neither normal nor necessary, but it is in fact not normal and not necessary. You might not be compatible with everyone given the symptoms of your ADHD, but being screamed at, belittled, and ignored is not the price of living with it, regardless of your medication regimen.
posted by restless_nomad at 8:17 AM on August 14, 2023 [40 favorites]
You say “ My partner lately avoids me, screams at me, and generally makes me feel like I’m unwelcome around them.”
Yes, the drugs are in some sense a side issue--this has to be addressed first or this relationship isn't worth saving.
Your partner does have the right to decide what living conditions are intolerable for them to stay in in the long term, whether it's "reasonable" or not. But this all sounds a little odd in that you are not proposing to go off meds altogether or adopt some wildly experimental treatment modality. You are still trying to manage the problems, balancing benefits and side effects, and to manage them with doctor-recommended medication. (*) It sounds to me like they may be near the end of their rope with this relationship, to be honest--they don't think anything can work.
Are you guys in couples counseling? This seems like a situation where it could be genuinely beneficial, or, if not, clarifying on incompatibilities.
(*) Footnote on that: please make sure you've read up on seizure risks on high doses of Wellbutrin and discussed them with your doctor.
posted by praemunire at 8:18 AM on August 14, 2023 [5 favorites]
Yes, the drugs are in some sense a side issue--this has to be addressed first or this relationship isn't worth saving.
Your partner does have the right to decide what living conditions are intolerable for them to stay in in the long term, whether it's "reasonable" or not. But this all sounds a little odd in that you are not proposing to go off meds altogether or adopt some wildly experimental treatment modality. You are still trying to manage the problems, balancing benefits and side effects, and to manage them with doctor-recommended medication. (*) It sounds to me like they may be near the end of their rope with this relationship, to be honest--they don't think anything can work.
Are you guys in couples counseling? This seems like a situation where it could be genuinely beneficial, or, if not, clarifying on incompatibilities.
(*) Footnote on that: please make sure you've read up on seizure risks on high doses of Wellbutrin and discussed them with your doctor.
posted by praemunire at 8:18 AM on August 14, 2023 [5 favorites]
We resolved disagreements about treatment strategy by deciding to end the relationship.
posted by Juniper Toast at 8:22 AM on August 14, 2023 [15 favorites]
posted by Juniper Toast at 8:22 AM on August 14, 2023 [15 favorites]
I agree with the others who have said your partner's behavior is unacceptable, full stop.
Regarding your medications: I would encourage you to work with your doctor to look for a treatment regime that has minimal side effects. There are second and third line ADHD medications that may serve you well. For example, modafinil is related to stimulants, but doesn't cause the side effects (jitters, appetite suppression) associated with stimulants like adderal.
posted by Winnie the Proust at 8:30 AM on August 14, 2023 [4 favorites]
Regarding your medications: I would encourage you to work with your doctor to look for a treatment regime that has minimal side effects. There are second and third line ADHD medications that may serve you well. For example, modafinil is related to stimulants, but doesn't cause the side effects (jitters, appetite suppression) associated with stimulants like adderal.
posted by Winnie the Proust at 8:30 AM on August 14, 2023 [4 favorites]
There's room in a healthy relationship for uncomfortable discussions about how mental health issues and treatments affect both people. That can be painful, but still loving and respectful. It should not involve screaming. Someone who screamed at me is not someone I would feel I could safely have that vulnerable conversation with.
But for your specific question - we both have mental health issues in this house. Mine is more run of the mill and responsive to treatment and the consequences when it's mismanaged are that chores don't get done and I'm not pleasant to be around. His are more "serious long term impact on our shared lives and goals, can escalate to hospitalization" stuff. So it feels, and is, unbalanced and that's hard to work through.
But for me, basically, he doesn't get involved in my actual treatment. I do inform him if I'm changing meds or doses and I want to know if he notices something about the way I act during that transition period that I might not be aware of, or that's affecting him, and would include that information in check ins with my care provider. But mostly he's hands-off.
My involvement with him varies but we do both agree that he needs to be on meds, and that any tapering or change needs to happen in very close consultation and supervision by his providers, because past history shows that med switches are a dangerous time. If he wants to try a med change and his doctors agree, even though it's scary as shit for me, I hope for the best and go along with it.
There was a time I needed him to be in therapy for me to be able to stay with him. He's very stable now so that's no longer a thing, but we do have a long standing agreement that if I ever get worried about his stability again I can ask him to resume therapy and he understands that depending on the situation, that could be a deal breaker for me if he won't.
Basically it boils down to: I need him to be actively participating with his providers to manage his serious health condition. I am willing to do a certain amount of ultimatum-ing about that because of the past history of what happens when he doesn't. I'm fortunate that he agrees with me that where I've drawn that line is reasonable. Beyond that, even when the specific decisions worry me, I believe he is the expert on his own experience, and I need to stand way back and leave the specific decisions to him and his treatment team. I may provide feedback about what I notice or how it affects me, but the decisions are his to make and I'm willing to do a lot of accommodating on my end to work around whatever he needs to manage symptoms that are a lot worse for him than whatever frustrations they create for me.
posted by Stacey at 8:34 AM on August 14, 2023 [25 favorites]
But for your specific question - we both have mental health issues in this house. Mine is more run of the mill and responsive to treatment and the consequences when it's mismanaged are that chores don't get done and I'm not pleasant to be around. His are more "serious long term impact on our shared lives and goals, can escalate to hospitalization" stuff. So it feels, and is, unbalanced and that's hard to work through.
But for me, basically, he doesn't get involved in my actual treatment. I do inform him if I'm changing meds or doses and I want to know if he notices something about the way I act during that transition period that I might not be aware of, or that's affecting him, and would include that information in check ins with my care provider. But mostly he's hands-off.
My involvement with him varies but we do both agree that he needs to be on meds, and that any tapering or change needs to happen in very close consultation and supervision by his providers, because past history shows that med switches are a dangerous time. If he wants to try a med change and his doctors agree, even though it's scary as shit for me, I hope for the best and go along with it.
There was a time I needed him to be in therapy for me to be able to stay with him. He's very stable now so that's no longer a thing, but we do have a long standing agreement that if I ever get worried about his stability again I can ask him to resume therapy and he understands that depending on the situation, that could be a deal breaker for me if he won't.
Basically it boils down to: I need him to be actively participating with his providers to manage his serious health condition. I am willing to do a certain amount of ultimatum-ing about that because of the past history of what happens when he doesn't. I'm fortunate that he agrees with me that where I've drawn that line is reasonable. Beyond that, even when the specific decisions worry me, I believe he is the expert on his own experience, and I need to stand way back and leave the specific decisions to him and his treatment team. I may provide feedback about what I notice or how it affects me, but the decisions are his to make and I'm willing to do a lot of accommodating on my end to work around whatever he needs to manage symptoms that are a lot worse for him than whatever frustrations they create for me.
posted by Stacey at 8:34 AM on August 14, 2023 [25 favorites]
I don't think you are the problem. Your partner's behavior sounds abusive. You are blamed for everything wrong in the relationship.
lack of empathy
they even contemplated leaving me over it
My partner lately avoids me, screams at me, and generally makes me feel like I’m unwelcome around them
That's horrible. My ex- was brutal to me when I was depressed, simply refused to help by going for walks with me, blamed everything on my depression. We went to couples counseling, the therapist recognized the abuse, and over some time, I realized I was much better off without him.
Some of the effects of depression are irritability, low mood, low energy. That's not super-fun to live with, but it sounds like you feel your depression is well-controlled. ADHD - mislaying things, variable energy/ attention - is annoying. Surely your partner has annoying traits in addition to the abusive traits of screaming, blaming, punishing, controlling.
You are the one who decides about your treatment, and unless you decide to not treat a serious disease, your partner must respect your decisions. Please talk to a therapist who understands domestic abuse.
I have ADHD and can't take Welbutrin or stimulants. I drink 2 - 2.5 cups of coffee, which helps, and I use as many coping mechanisms as possible.
posted by theora55 at 8:45 AM on August 14, 2023 [8 favorites]
lack of empathy
they even contemplated leaving me over it
My partner lately avoids me, screams at me, and generally makes me feel like I’m unwelcome around them
That's horrible. My ex- was brutal to me when I was depressed, simply refused to help by going for walks with me, blamed everything on my depression. We went to couples counseling, the therapist recognized the abuse, and over some time, I realized I was much better off without him.
Some of the effects of depression are irritability, low mood, low energy. That's not super-fun to live with, but it sounds like you feel your depression is well-controlled. ADHD - mislaying things, variable energy/ attention - is annoying. Surely your partner has annoying traits in addition to the abusive traits of screaming, blaming, punishing, controlling.
You are the one who decides about your treatment, and unless you decide to not treat a serious disease, your partner must respect your decisions. Please talk to a therapist who understands domestic abuse.
I have ADHD and can't take Welbutrin or stimulants. I drink 2 - 2.5 cups of coffee, which helps, and I use as many coping mechanisms as possible.
posted by theora55 at 8:45 AM on August 14, 2023 [8 favorites]
Agree that your partner's behavior itself is unacceptable, full stop. Nothing you can do is as important as your partner understanding that they cannot scream at you about your medication choices.
My partner’s fear of me being off medication is unfounded. I won’t be off medication. I’ll be off Adderall for at least a while, to see what extra Wellbutrin can do for me instead.
No, you won't be "off medication" in the most literal sense. What your partner sees and what is making them afraid is that you will be off the medication that demonstrably helps your symptoms. Yes, you have a good reason, and yes, it's possible that the new treatment will work as well as the old, and be better for you! There's also a chance it will not, in which case your partner is looking at a stretch, and possibly a long one, of unmanaged symptoms. What does that possibility mean for them?
Again, none of that justifies their treatment of you. It is not okay for partners to scream at each other. Everyone's body is their own and they are the final arbiter of what happens to it. However: this means that the people who love you may feel powerless and afraid in the face of your decisions. Ideally they would handle that fear and powerlessness in perfect healthy constructive ways but they often do not.
If this is a relationship you actually want to keep, as opposed to merely being afraid of the logistics of it ending, I would suggest couples' counseling, so that you and your partner can learn constructive ways of addressing these decisions and the fears/feelings they bring up.
posted by We put our faith in Blast Hardcheese at 9:01 AM on August 14, 2023 [13 favorites]
My partner’s fear of me being off medication is unfounded. I won’t be off medication. I’ll be off Adderall for at least a while, to see what extra Wellbutrin can do for me instead.
No, you won't be "off medication" in the most literal sense. What your partner sees and what is making them afraid is that you will be off the medication that demonstrably helps your symptoms. Yes, you have a good reason, and yes, it's possible that the new treatment will work as well as the old, and be better for you! There's also a chance it will not, in which case your partner is looking at a stretch, and possibly a long one, of unmanaged symptoms. What does that possibility mean for them?
Again, none of that justifies their treatment of you. It is not okay for partners to scream at each other. Everyone's body is their own and they are the final arbiter of what happens to it. However: this means that the people who love you may feel powerless and afraid in the face of your decisions. Ideally they would handle that fear and powerlessness in perfect healthy constructive ways but they often do not.
If this is a relationship you actually want to keep, as opposed to merely being afraid of the logistics of it ending, I would suggest couples' counseling, so that you and your partner can learn constructive ways of addressing these decisions and the fears/feelings they bring up.
posted by We put our faith in Blast Hardcheese at 9:01 AM on August 14, 2023 [13 favorites]
My partner and I have some lines drawn around reasonable management of mental health conditions, but those are informed lines that acknowledge no one thing is ever going to be The Thing That Works Forever. This is a Team Us understanding though, mostly meaning that doing nothing isn't sustainable and we both recognize that, while at the same time recognizing these aren't (or may not always be) easy fixes. This is us working together on the problem, and that may mean sometimes having some difficult conversations - including "you have to step up on XYZ and I need to not be the person managing that, I get that this is hard but it's a really big deal and I'm just looking for an upward trend rather than total instant perfection" and also "if I get scared enough I have to get professionals involved whether you like it or not" - but still caring ones.
Your partner has pretty much already told you they're leaving and that they think you're a monster if you don't follow their treatment plan even if it gives you a stroke. (As if they'd stay if you had a stroke. This is a person who'd dump you in a hospital parking lot and drive off.) And yes, that fucking hurts to hear, but you should take them at their word and prepare for next steps. If it helps you to prepare to split up while maintaining the faint hope that this will shake them out of their fucking bullshit and realize they actually care about you, you can do that, but it certainly sounds like this is a person of extremely limited empathy and willingness to make any effort and you've hit their wall.
I'm sorry. This sucks. Nobody deserves to be treated like this in general, and you specifically do not deserve to be treated like this, this is not happening because you are bad or unlovable or not entitled to the full regard and care of a partner. This is just happening because the person you're with has a very limited capacity for care, which is only going to suck worse for them as they get older (even if their partners stay real young).
posted by Lyn Never at 9:05 AM on August 14, 2023 [8 favorites]
Your partner has pretty much already told you they're leaving and that they think you're a monster if you don't follow their treatment plan even if it gives you a stroke. (As if they'd stay if you had a stroke. This is a person who'd dump you in a hospital parking lot and drive off.) And yes, that fucking hurts to hear, but you should take them at their word and prepare for next steps. If it helps you to prepare to split up while maintaining the faint hope that this will shake them out of their fucking bullshit and realize they actually care about you, you can do that, but it certainly sounds like this is a person of extremely limited empathy and willingness to make any effort and you've hit their wall.
I'm sorry. This sucks. Nobody deserves to be treated like this in general, and you specifically do not deserve to be treated like this, this is not happening because you are bad or unlovable or not entitled to the full regard and care of a partner. This is just happening because the person you're with has a very limited capacity for care, which is only going to suck worse for them as they get older (even if their partners stay real young).
posted by Lyn Never at 9:05 AM on August 14, 2023 [8 favorites]
I agree with the consensus that the main issue seems to be that your partner is abusive, and there is a big difference between an untreated mental health condition and changing your treatment options with medical consultation. You obviously are taking your conditions seriously and are putting forth effort to find solutions - what is your partner doing to find solutions other than rotating between avoiding and screaming at you?
In a future relationship, I'd suggest focusing more on which symptoms are a problem, and how you might compensate your partner for those - like, if while you go off Adderall you start being worse at household management requiring your partner to pick up the slack, you could offer to be assigned more household duties. But I sorta think this is a moot point for your current partner, who really sounds at the very least a bad match for you.
posted by coffeecat at 9:14 AM on August 14, 2023 [2 favorites]
In a future relationship, I'd suggest focusing more on which symptoms are a problem, and how you might compensate your partner for those - like, if while you go off Adderall you start being worse at household management requiring your partner to pick up the slack, you could offer to be assigned more household duties. But I sorta think this is a moot point for your current partner, who really sounds at the very least a bad match for you.
posted by coffeecat at 9:14 AM on August 14, 2023 [2 favorites]
Your treatment strategy is primarily between you and your doctor.
You deserve understanding and empathy from your partner, and it does not sound like they are providing these here.
I think that the conversation you have with them should be about that.
posted by zippy at 9:18 AM on August 14, 2023 [1 favorite]
You deserve understanding and empathy from your partner, and it does not sound like they are providing these here.
I think that the conversation you have with them should be about that.
posted by zippy at 9:18 AM on August 14, 2023 [1 favorite]
My partner lately avoids me, screams at me, and generally makes me feel like I’m unwelcome around them.
I'm sorry, but the evidence indicates that your partner has already left you, even though they still live with you. Their threats to leave and their avoidance makes me believe that your pair bond is pretty much broken. Threatening to leave is bringing out the really big guns. It almost always occurs when the partner threatening to leave is not yet able to actually make a full break but wants to. And even if it is only being used for leverage to make the person who is being threaten change, and was only voiced because the self control of the person voicing the threat broke during a period of strong feelings, the one hearing the threat very often cannot ever return to the trust level necessary to continue in the relationship. Basically when someone tells you they don't love you anymore they damage your bond with them. Unless you have an unstable attachment pattern where you want to be desperately pursuing someone who repeatedly rejects you, you will find it really hard to continue feeling positive towards them.
There is a major chance that even you worked extremely hard to take your medication when they felt you should take it, that it would make no difference whatsoever to their feelings about you. They appear to have developed an aversion to you and it is vanishingly rare for a relationship to recover from that. Their thoughts, rather than your medication usage are the problem here. Many people stay with partners that have issues or are unstable, or who are pretty much not functional without behaving unkindly. They may be behaving this way because of your medication use, but its not the cause. If they were on your side they wouldn't be doing it. They are behaving that way because they are not on your side anymore and they don't accept you being who you are.
May advice to you is to take your medication in the way that makes you the most functional, in your own opinion, for your own sake. How you manage it, considering side effects and the need to function is up to you. I'd also recommend that you to give them as much space as you possibly can. Every bad encounter where they snub you, or you trigger them into feeling overwhelmed and wanting to avoid you is going to hurt both you, and them and continue to damage the relationship. Instead of a balance where they are avoiding you, flip it to one where you are avoiding them. Be kind, don't issue ultimatums or reproaches as that will only lead to more painful interactions, but draw way, way back and give thought to alternative long term plans.
If there is any way to repair a relationship where one or both sides are so far apart that they are acting unkind to each other, it's to give the participants enough space for their moods to change, and for them to miss the good things in the relationship. And if the relationship is on the way out, limiting interactions to only critically necessary ones will make it easier for both of you to manage those interactions so that they are not hurtful.
posted by Jane the Brown at 9:28 AM on August 14, 2023 [8 favorites]
I'm sorry, but the evidence indicates that your partner has already left you, even though they still live with you. Their threats to leave and their avoidance makes me believe that your pair bond is pretty much broken. Threatening to leave is bringing out the really big guns. It almost always occurs when the partner threatening to leave is not yet able to actually make a full break but wants to. And even if it is only being used for leverage to make the person who is being threaten change, and was only voiced because the self control of the person voicing the threat broke during a period of strong feelings, the one hearing the threat very often cannot ever return to the trust level necessary to continue in the relationship. Basically when someone tells you they don't love you anymore they damage your bond with them. Unless you have an unstable attachment pattern where you want to be desperately pursuing someone who repeatedly rejects you, you will find it really hard to continue feeling positive towards them.
There is a major chance that even you worked extremely hard to take your medication when they felt you should take it, that it would make no difference whatsoever to their feelings about you. They appear to have developed an aversion to you and it is vanishingly rare for a relationship to recover from that. Their thoughts, rather than your medication usage are the problem here. Many people stay with partners that have issues or are unstable, or who are pretty much not functional without behaving unkindly. They may be behaving this way because of your medication use, but its not the cause. If they were on your side they wouldn't be doing it. They are behaving that way because they are not on your side anymore and they don't accept you being who you are.
May advice to you is to take your medication in the way that makes you the most functional, in your own opinion, for your own sake. How you manage it, considering side effects and the need to function is up to you. I'd also recommend that you to give them as much space as you possibly can. Every bad encounter where they snub you, or you trigger them into feeling overwhelmed and wanting to avoid you is going to hurt both you, and them and continue to damage the relationship. Instead of a balance where they are avoiding you, flip it to one where you are avoiding them. Be kind, don't issue ultimatums or reproaches as that will only lead to more painful interactions, but draw way, way back and give thought to alternative long term plans.
If there is any way to repair a relationship where one or both sides are so far apart that they are acting unkind to each other, it's to give the participants enough space for their moods to change, and for them to miss the good things in the relationship. And if the relationship is on the way out, limiting interactions to only critically necessary ones will make it easier for both of you to manage those interactions so that they are not hurtful.
posted by Jane the Brown at 9:28 AM on August 14, 2023 [8 favorites]
What has your doctor said about your issues with Adderall side effects? I’m surprised they haven’t suggested trying Vyvanse or Ritalin/Concerta as a possible alternative stimulant. (Strattera is not a stimulant and can be used in combination with stimulants—obviously it wasn’t a good fit for you so I’m not suggesting that, just pointing it out.)
posted by staggernation at 9:44 AM on August 14, 2023
posted by staggernation at 9:44 AM on August 14, 2023
Strattera is not a stimulant... as staggernation has mentioned, on preview. Also, are you aware that you're at pretty much the absolute max of Wellbutrin? Beyond 450mg, most people start courting seizures.
Adderall is an amphetamine salt type ADHD med. They punch harder. It sounds like you're crashing really hard... Vyvanse is in the same group but is a prodrug, and is very smooth & longer lasting for most people, if the crash is the main problem. Methylphenidates are another option you might want to look into: they're stimulants like amphetamines but they don't punch as hard and may work better for you.
But anyways, that's just info/opinion I wanted to share with you because I'm like you. For your actual question...
Everyone's addressed the worrying behavior of your partner. Just want to ditto that.
I (ADHD inattentive, on Wellbutrin & vyvanse) don't typically have disagreements with my spouse about my treatment because it's MY treatment. If I want his opinion, I would be clear I was asking for it. I share stuff with him about my treatment and when things are going really bad, we talk (sometimes yell) about how that's affecting him. Mainly it's hard for him when it feels like absolutely everything is on his shoulders. ADHD inattentive is SUCH a struggle but a lot of that struggle is internal, so he doesn't see how bad it is inside my brain. He has his own therapist now to talk things out with, and I've been making a point to externalize some of the struggle so he can at least see that I do care, I do, I'm just having a hard time functioning sometimes. A lot.
He also sees how freaking AMAZING I am at certain things, like outside-the-box solutions on the fly. So the irritation of "you started three separate organizing projects without finishing any of them and now I can't use the living room" is a bit soothed by "you got the washer working through cleverness and stubbornness" and it's all balanced by a lot of love between us.
We did have arguments about the treatment for our son, who also is ADHD inattentive (my bad). He's young, in elementary school, and while I thought a very low dose of stimulant meds was worth trying, my husband was kind of horrified. We should have had calm, productive discussions about it, but honestly we had short heated arguments. Then we'd stop talking about it for the rest of the day to calm down. Through the repeated arguments, I realized that he was thinking of the kids he went to school with, many of whom got into heavy drugs in high school. He went to a huge public school in a VERY rich town during the time when adhd meds may have been over prescribed to boys who acted out. The kids he knew often had parents with money but perhaps not a lot of time for their children. But he wasn't thinking all that out, he had just learned through experience that giving kids stimulants = setting kids up for drug addiction.
I showed him studies and stuff, and attempted to stop scoffing and do more emotional "I hear your concerns and am taking them seriously". I think he's still a little wary generally of stimulants, but closer to a reasonable level of caution which I think is healthy. And my son clearly had an easier time with basic attention on the medication.
Your partner is like the opposite of mine. Your partner is scared of your symptoms off of stimulants. Did they have issues with you in the evenings or whenever your Adderall would wear off? (I'm curious if they really can pinpoint that.) Or are there particular catastrophes they imagine would happen without medication? Do they know what your symptoms are specifically, and how they're affected (or not) by various meds? Is there some background stuff going on for your partner, like other fears, experiences in the past with other people?
Ugh I'm sorry, I don't have a ton of time to make this all shorter and more focused but I hope there might be something helpful in here.
posted by Baethan at 10:22 AM on August 14, 2023 [5 favorites]
Adderall is an amphetamine salt type ADHD med. They punch harder. It sounds like you're crashing really hard... Vyvanse is in the same group but is a prodrug, and is very smooth & longer lasting for most people, if the crash is the main problem. Methylphenidates are another option you might want to look into: they're stimulants like amphetamines but they don't punch as hard and may work better for you.
But anyways, that's just info/opinion I wanted to share with you because I'm like you. For your actual question...
Everyone's addressed the worrying behavior of your partner. Just want to ditto that.
I (ADHD inattentive, on Wellbutrin & vyvanse) don't typically have disagreements with my spouse about my treatment because it's MY treatment. If I want his opinion, I would be clear I was asking for it. I share stuff with him about my treatment and when things are going really bad, we talk (sometimes yell) about how that's affecting him. Mainly it's hard for him when it feels like absolutely everything is on his shoulders. ADHD inattentive is SUCH a struggle but a lot of that struggle is internal, so he doesn't see how bad it is inside my brain. He has his own therapist now to talk things out with, and I've been making a point to externalize some of the struggle so he can at least see that I do care, I do, I'm just having a hard time functioning sometimes. A lot.
He also sees how freaking AMAZING I am at certain things, like outside-the-box solutions on the fly. So the irritation of "you started three separate organizing projects without finishing any of them and now I can't use the living room" is a bit soothed by "you got the washer working through cleverness and stubbornness" and it's all balanced by a lot of love between us.
We did have arguments about the treatment for our son, who also is ADHD inattentive (my bad). He's young, in elementary school, and while I thought a very low dose of stimulant meds was worth trying, my husband was kind of horrified. We should have had calm, productive discussions about it, but honestly we had short heated arguments. Then we'd stop talking about it for the rest of the day to calm down. Through the repeated arguments, I realized that he was thinking of the kids he went to school with, many of whom got into heavy drugs in high school. He went to a huge public school in a VERY rich town during the time when adhd meds may have been over prescribed to boys who acted out. The kids he knew often had parents with money but perhaps not a lot of time for their children. But he wasn't thinking all that out, he had just learned through experience that giving kids stimulants = setting kids up for drug addiction.
I showed him studies and stuff, and attempted to stop scoffing and do more emotional "I hear your concerns and am taking them seriously". I think he's still a little wary generally of stimulants, but closer to a reasonable level of caution which I think is healthy. And my son clearly had an easier time with basic attention on the medication.
Your partner is like the opposite of mine. Your partner is scared of your symptoms off of stimulants. Did they have issues with you in the evenings or whenever your Adderall would wear off? (I'm curious if they really can pinpoint that.) Or are there particular catastrophes they imagine would happen without medication? Do they know what your symptoms are specifically, and how they're affected (or not) by various meds? Is there some background stuff going on for your partner, like other fears, experiences in the past with other people?
Ugh I'm sorry, I don't have a ton of time to make this all shorter and more focused but I hope there might be something helpful in here.
posted by Baethan at 10:22 AM on August 14, 2023 [5 favorites]
The lack of empathy is disheartening. The fact that they even contemplated leaving me over it is frightening. My partner lately avoids me, screams at me, and generally makes me feel like I’m unwelcome around them.
This sounds like a dealbreaker to me and I echo the sentiments and actions above.
What this same discussion looks like respectfully is even if things are emotional, they are overall not at a high volume. More like:
“I find mornings really hard when you don’t take your meds because…(dog goes unfed, garage door gets left open, etc.) When that happens, I feel (hopeless, responsible, frustrated, etc.) Can you ask your doctor about (whatever), or have you taken account of (whatever)?”
I am not personally frightened of the prospect of my partner leaving if he really can’t live with something. I wouldn’t want that relationship for him (living with something intolerable) or for me (living with someone who finds me intolerable.) Sometimes we each have had moments where we weren’t communicating the best and things escalated fast, but those have just been moments. And we’ve known that when we always committed to finding a way that works for both of us, not by “do this” but by sharing how our decisions are taking each other’s needs into account.
I would suggest…get really really okay with the idea that this may be a dealbreaker and you’re okay with that. Then you can let him know that a) you’re committed to finding medication that works for you and b) you’re committed to a relationship that works for both of you, including you. That doesn’t include screaming and silent treatment and shaming. And it includes addressing your ADHD with observations from them but in a way that makes sense for you. If they can’t be on board with that, it’s good to create that exit ramp.
posted by warriorqueen at 10:29 AM on August 14, 2023 [8 favorites]
This sounds like a dealbreaker to me and I echo the sentiments and actions above.
What this same discussion looks like respectfully is even if things are emotional, they are overall not at a high volume. More like:
“I find mornings really hard when you don’t take your meds because…(dog goes unfed, garage door gets left open, etc.) When that happens, I feel (hopeless, responsible, frustrated, etc.) Can you ask your doctor about (whatever), or have you taken account of (whatever)?”
I am not personally frightened of the prospect of my partner leaving if he really can’t live with something. I wouldn’t want that relationship for him (living with something intolerable) or for me (living with someone who finds me intolerable.) Sometimes we each have had moments where we weren’t communicating the best and things escalated fast, but those have just been moments. And we’ve known that when we always committed to finding a way that works for both of us, not by “do this” but by sharing how our decisions are taking each other’s needs into account.
I would suggest…get really really okay with the idea that this may be a dealbreaker and you’re okay with that. Then you can let him know that a) you’re committed to finding medication that works for you and b) you’re committed to a relationship that works for both of you, including you. That doesn’t include screaming and silent treatment and shaming. And it includes addressing your ADHD with observations from them but in a way that makes sense for you. If they can’t be on board with that, it’s good to create that exit ramp.
posted by warriorqueen at 10:29 AM on August 14, 2023 [8 favorites]
My partner lately avoids me, screams at me, and generally makes me feel like I’m unwelcome around them
I stopped reading here. This isn't a meds problem, it's a partner problem. It's a deal-breaker. Nobody deserves this from someone who is supposed to love and care for them.
posted by invincible summer at 1:31 PM on August 14, 2023 [5 favorites]
I stopped reading here. This isn't a meds problem, it's a partner problem. It's a deal-breaker. Nobody deserves this from someone who is supposed to love and care for them.
posted by invincible summer at 1:31 PM on August 14, 2023 [5 favorites]
My partner and I have a Venn diagram of mental and neurodivergent conditions. I’m the one without ADHD and sometimes I get irritated by how his ADHD impacts me or our home life. We deal with it by talking to a neuro-aware couple’s counselor and by saying “thing X affects me this way, how could we deal with it as a couple?” I have no input on his med strategy besides listening to what he cares to share with me about what he and his provider have decided. The kind of approach your partner is taking sounds abusive and totally outside the way a healthy relationship should function. Just because your brain works differently doesn’t mean you’re broken or that being treated like this is in any way acceptable.
posted by matildaben at 5:00 PM on August 14, 2023 [1 favorite]
posted by matildaben at 5:00 PM on August 14, 2023 [1 favorite]
you should make personal medical decisions based solely on your own informed opinion of what is in your best interest as an individual, not based on what might give the couple you are part of the best chance of surviving. you should make your medical decisions before you contemplate your relationship decisions. in this case you want to find out if you can function well without stimulants and the only way to find out is to experiment. so you should do that.
you should then expect your partner to move out, because they said they can’t live with you when you’re not taking stimulants and presumably they said that because they are genuinely unable to cope with whatever behavior and “effects on them” you declined to describe in any way. If they don’t move out, that will indicate that they have been making empty threats to intimidate and control you, and in that case you should move out.
there is no reason you have to break up just because you both realize living together is more stressful than it’s worth. not unless one of you wants to. you can have both a partner and your own place. your partner may or may not realize this.
you should not take drugs whose medical effects you don’t like, just to make someone stay with you. even if it works.
posted by queenofbithynia at 5:57 PM on August 14, 2023 [4 favorites]
you should then expect your partner to move out, because they said they can’t live with you when you’re not taking stimulants and presumably they said that because they are genuinely unable to cope with whatever behavior and “effects on them” you declined to describe in any way. If they don’t move out, that will indicate that they have been making empty threats to intimidate and control you, and in that case you should move out.
there is no reason you have to break up just because you both realize living together is more stressful than it’s worth. not unless one of you wants to. you can have both a partner and your own place. your partner may or may not realize this.
you should not take drugs whose medical effects you don’t like, just to make someone stay with you. even if it works.
posted by queenofbithynia at 5:57 PM on August 14, 2023 [4 favorites]
As a partner, I’m going to dissent from the crowd a bit. There’s another side we haven’t heard, and a whole lot a counsellor needs to hear. Untreated ADHD can look like a lot of things, up to and including abuse if RSD is part of the picture. (Like is your partner the primary abuser, is it reactive abuse, there are a lot of questions that need to be answered. Not by you here necessarily, but in front of a counsellor for sure. I have no idea and am making no assumptions about you, I’m just saying things can be complex, and from your question alone, there’s no way to know how complex things are at your place.)
Medication trial and error can be a lot of stress for a relationship. It’s usually at least a year for every new drug trialled or ended (ramping it up, titrating, refining, crossover drugs may need to be involved)… if one drug helped manage behaviour your partner finds untenable as part of their life, I can understand why the attachment to it is there (and maybe, fear, depending, again I have no idea based on your question). I mean you say it’ll be fine because you’ll be on Wellbutrin, but with psych meds no one knows anything until it’s tried.
Partner has a right to determine what’s acceptable on their side, you have a right to what goes into your body (of course) - I agree with spending time apart while you’re figuring things out.
posted by cotton dress sock at 11:50 AM on August 15, 2023 [1 favorite]
Medication trial and error can be a lot of stress for a relationship. It’s usually at least a year for every new drug trialled or ended (ramping it up, titrating, refining, crossover drugs may need to be involved)… if one drug helped manage behaviour your partner finds untenable as part of their life, I can understand why the attachment to it is there (and maybe, fear, depending, again I have no idea based on your question). I mean you say it’ll be fine because you’ll be on Wellbutrin, but with psych meds no one knows anything until it’s tried.
Partner has a right to determine what’s acceptable on their side, you have a right to what goes into your body (of course) - I agree with spending time apart while you’re figuring things out.
posted by cotton dress sock at 11:50 AM on August 15, 2023 [1 favorite]
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I don’t think that’s a relationship worth staying in unless they are under some new, time limited, extreme stress and not normally like that, or they’re actively trying to change these things, or you’re getting something from being with them that you haven’t mentioned here that makes up for all that.
posted by wheatlets at 8:09 AM on August 14, 2023 [52 favorites]