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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 44. This is the beginning of the thread.
Posted by g_g_g_unit on October 21, 2010, at 2:52:11
So I've been seeing this GP who strongly advocates ADD recognition, and who I advised that I experiment with the left-over dexedrine I had over this past week.
"Awakening" wouldn't really be too strong a word to describe my experience (as with all stimulants) - I rapidly transform from a motivationless, foggy, intellectually wanting patient into a bright, dynamic, high-functioning individual. I've struggled to finish a single book over the past year and a half, yet am able to bound through and process information on stimulants to a degree I've never experienced before. Despite being academically gifted, I've never been able to read for longer than 45 minutes at a time, but can read for two hours+ with ease on stimulants.
So I tell my psychiatrist this today, and her response is that "stimulants improve everyone's intelligence .. that's why they're abused in America". She then writes me a script for abilify and says that that should help fix my concentration problems.
I smiled, nodded politely and left, and then came home and felt like putting my fist through the wall.
Is that an extreme reaction? It seems like every step I take forwards, I'm being forced back three. Every door I open leads to a brick wall.
Do I try the abilify? I'm wound up and unable to sleep on the clomipramine, so is it just gonna make things worse? I don't wanna take it out of spite, but I know that's an immature stance.
I'm seeing the ADD guy again tomorrow because he's looking at arranging a referral treatment for me. I think that if the next psychiatrist I meet doesn't wanna listen to me, then I give up. After 8+ psychiatrists, I have not met a single one who offers me more than lip service, who seems to care about the wellbeing of me as a person, who will listen, pay attention, or exhibit anything resembling a soul.
Posted by Christ_empowered on October 21, 2010, at 3:43:03
In reply to psychiatry is a joked dreamed up by Kafka +Abilify, posted by g_g_g_unit on October 21, 2010, at 2:52:11
What I've find is that often, the worst part about psychiatry is...psychiatrists.
My experience with psychiatrists has also been decidedly negative. I've had ex-shrinks who broke confidentiality--in bars (in a small southern town, that's a big freakin' deal).
I don't know why psychiatrists have to be so terrible. You'd think that the private practice ones would at least be kind of nice--I mean, they make a pretty penny, and its not like the state is picking up the tab like in public mental health--but...no. That's just not how it is.
I personally wouldn't take Abilify unless you actually needed, you know, a NEUROLEPTIC, b/c that really is what Abilify is, all the marketing crap aside. I mean, I take a whopping 30mgs/day of the stuff, but that's only because I can tolerate it and it keeps me out of a mental hospital where they'd probably try to pump me full of Haldol (again).
You can refuse drugs. I know someone who was given an "off-label" Rx for a low dose of Abilify for depression. She brought the filled prescription back to her (private practice) doc, told him she wasn't going to take it OR Cymbalta, and that she needed something effective, pronto. He put her on a stimulant.
That may or may not work for you. The sad thing about shrinks is that you sometimes have to "stick up" for yourself, like you're dealing with an overgrown (and overpaid) schoolyard bully.
Good luck.
Posted by g_g_g_unit on October 21, 2010, at 4:28:39
In reply to Re: psychiatry is a joked dreamed up by Kafka +Abilify, posted by Christ_empowered on October 21, 2010, at 3:43:03
Thanks, Christ_Empowered.
For the record, I have always been the most politically apathetic person you could find. But there's something about my experience today that really struck a chord of resistance, and I truly, deeply feel that in a century, this era of prescription-happy quacks will be looked on as a cruel joke.
I'll be the first to admit that I suffer from intense anxiety and OCD. If my psychiatrist had compromised and suggested we try stimulants and if I can't handle them, turn to something like abilify, I would've been okay with that. But the willingness to hand out neuroleptics off-label instead of something infinitely safer yet also abusable is ridiculous (nevermind the fact that Dexedrine provided significant anxiety relief on the handful of occasions I tried it).
I would love to deal with a GP exclusively but GP's can't prescribe stimulants in Australia.
I also wish I could stand up to my psychiatrist. Believe me, voicing my positive reaction to stimulants alone was a huge step, given how shy and mild mannered I am. I even suggested we wait for the results of some neuropsychiatric testing I'm having before turning to a neuroleptic to see whether it shows positive or negative for ADD, but she said that wouldn't be necessary.
Please forgive me if this causes offense in any way, but as a (non-practicing) Jew, I would love to know if anyone has found Jewish psychiatrists to be more genial. I have yet to meet a Jewish practitioner/specialist in other medical fields who I disliked, and am wondering if I may get on best with someone who shares my religion.
Posted by Christ_empowered on October 21, 2010, at 4:45:18
In reply to Re: psychiatry is a joked dreamed up by Kafka +Abilify » Christ_empowered, posted by g_g_g_unit on October 21, 2010, at 4:28:39
I don't know if the shrink's religious preference would make a difference or not. When I get insurance, I'd kind of like to get myself a Christian shrink, to see how it goes...my guess is that they'd spend a little bit more time w/ the patients and stop and think before writing a script for whatever is "in" at the moment. Then again...sometimes I think Dr. Thomas Szasz ("The Myth Of Mental Illness") has some points. Psychiatry kind of is a quasi-religious belief system; I kind of suspect that, at least while playing the shrink/high priest(ess) role, the shrink adapts his/her worldview and preconceived notions, religious and otherwise, to the psychiatric belief system, not the other way around.
Or maybe not.
Posted by g_g_g_unit on October 21, 2010, at 5:12:14
In reply to Re: psychiatry is a joked dreamed up by Kafka +Abilify, posted by Christ_empowered on October 21, 2010, at 4:45:18
Well, for what it's worth, the kindest and most understanding mental-health professional I've had the pleasure of working with was a Christian GP in my former country who dealt with ADD. Unfortunately, the complexity of my case (incl. the depression and OCD) was kinda outside his realm of expertise, but in terms of providing ADD care, he was a saint who never once questioned me or second-guessed my intentions.
Posted by linkadge on October 21, 2010, at 6:41:39
In reply to psychiatry is a joked dreamed up by Kafka +Abilify, posted by g_g_g_unit on October 21, 2010, at 2:52:11
Stimulants do not increase your intellegence.
They temporarily increase synaptic processing capacity, but this is not intellegence.
Plus, I think that long term stimulant use has made me dumber, but I'm not using it for IQ gains rather mood.
Linkadge
Posted by g_g_g_unit on October 21, 2010, at 6:51:19
In reply to Re: intellegence vs. motivation, posted by linkadge on October 21, 2010, at 6:41:39
Yeah, I never told her they increased my intelligence. I said they correct my difficulties processing information + my own thoughts, which I guess allows me to capitalize on my intelligence.
> Stimulants do not increase your intellegence.
>
> They temporarily increase synaptic processing capacity, but this is not intellegence.
>
> Plus, I think that long term stimulant use has made me dumber, but I'm not using it for IQ gains rather mood.
>
> Linkadge
Posted by Phillipa on October 21, 2010, at 10:27:29
In reply to Re: intellegence vs. motivation, posted by g_g_g_unit on October 21, 2010, at 6:51:19
I think I took a stimulant once in the late 60's to lose weight but took every other day. I just know I had no anxiety yet at all and couldn't stop washing windows, cleaning and rushing about. I guess they just stimulated me. At the end of the month supply which lasted two I couldn't sleep so I feel in anxiety prone not good at least for me. Phillipa
Posted by Maxime on October 21, 2010, at 11:16:22
In reply to Re: intellegence vs. motivation, posted by g_g_g_unit on October 21, 2010, at 6:51:19
> Yeah, I never told her they increased my intelligence. I said they correct my difficulties processing information + my own thoughts, which I guess allows me to capitalize on my intelligence.
>
>I like how you put that. That's how I feel about the Adderall I take.
Posted by Jay_Clockwork_Angels on October 21, 2010, at 17:38:57
In reply to Re: intellegence vs. motivation, posted by g_g_g_unit on October 21, 2010, at 6:51:19
> Yeah, I never told her they increased my intelligence. I said they correct my difficulties processing information + my own thoughts, which I guess allows me to capitalize on my intelligence.
>Well, I think it would be much, much better if you simply said that the med helps with the slow cognition (or 'dullness' or 'cloudiness') of whatever mental illness you are suffering with. With me, I've finely tuned the art of re-scripting words and language to make it tie into my *pain* as much as possible. EVEN if you don't have pain, put on the show, because it does and will persuade doctors. I know this doesn't sound very authentic, but I have become a very good actor to know what/and/or/how I have to do/say to get whatever (well, within reason) I need. It has taken me almost 20 years to do so. If it means bringing in 30 pages of medical literature supporting my use of something, or just simply mumbling in a tense voice that I am having a very bad dysphoric manic spell, it is mostly preconstructed and carefully thought out. This is the only way I have survived, and have gotten healthier.
Jay
Posted by linkadge on October 21, 2010, at 20:19:12
In reply to Re: intellegence vs. motivation » g_g_g_unit, posted by Jay_Clockwork_Angels on October 21, 2010, at 17:38:57
>This is the only way I have survived, and have >gotten healthier.
I personally would not condone faking any symptoms. This is what has ended up getting me more messed up than ever. As soon as I started becoming more honest about my symptoms, the more I recieved medications that actually worked. I personally think that faking symptoms is probably more common in bipolar spectrum disorders.
Mind you, sometimes it so happens that one is having an ok day on the day of the appointment. If this is the case, I think it is necessary to still convey a tone indicative of ones average mood over the time since the last appointment.
Linkadge
Posted by Maxime on October 21, 2010, at 22:07:35
In reply to Re: intellegence vs. motivation » g_g_g_unit, posted by Jay_Clockwork_Angels on October 21, 2010, at 17:38:57
I'm not judging you, I just want to make sure I understood your post. Are saying that over the years you have faked symptoms to get the med that you want? If that is the case, what made you feel like you had to do that? Were the doctors not listening to you? Did you do it to try a specific drug? And if the answer is yes, could you not just ask the pdoc to try the med?
I am sorry in advance if I misunderstood your post. Please set me straight on this one.
Posted by g_g_g_unit on October 22, 2010, at 1:54:34
In reply to Re: intellegence vs. motivation » g_g_g_unit, posted by Jay_Clockwork_Angels on October 21, 2010, at 17:38:57
I think it's an interesting and somewhat controversial point you bring up, and I agree with both you and linkadge.
I've found that a lot of psychiatric treatment revolves around semantics, and it's necessary for the patient to edit and/or emphasize certain symptoms/experiences over others in order to gain the most appropriate treatment at times. Like Jay says, it's a matter of survival, and confronting a psychiatrist is always in some ways a 'performance'.
Sometimes psychiatrists have stated that I present too well given the amount of distress I've described. Sometimes, I can't open up to a psychiatrist due to their awful bedside manner and they don't receive a complete picture of my symptoms. Sometimes they'll blindly challenge me on whether I'm actually suffering from symptoms I describe. Sometimes I didn't know that certain things (impulse issues, etc.) were actually psychiatric symptoms, which led to my ADHD going completely unrecognized for so long.
If I walked into a psychiatrist's office and just spewed out what an anxious mess I was, I'd be placed on something like an AP everytime, no questions asked. As I get a clearer picture of my problems, I've learned to pare my story down to the bare essentials and construct a clear narrative of my life.
I'm still learning of course - one recent slight I made was telling my psychologist that when I first became depressed, it felt like negative schizophrenia, which led to this whole recent schizo debacle. As I say, it's very much an issue of semantics because amotivation and cognitive problems could apply to a range of things.
> > Yeah, I never told her they increased my intelligence. I said they correct my difficulties processing information + my own thoughts, which I guess allows me to capitalize on my intelligence.
> >
>
> Well, I think it would be much, much better if you simply said that the med helps with the slow cognition (or 'dullness' or 'cloudiness') of whatever mental illness you are suffering with. With me, I've finely tuned the art of re-scripting words and language to make it tie into my *pain* as much as possible. EVEN if you don't have pain, put on the show, because it does and will persuade doctors. I know this doesn't sound very authentic, but I have become a very good actor to know what/and/or/how I have to do/say to get whatever (well, within reason) I need. It has taken me almost 20 years to do so. If it means bringing in 30 pages of medical literature supporting my use of something, or just simply mumbling in a tense voice that I am having a very bad dysphoric manic spell, it is mostly preconstructed and carefully thought out. This is the only way I have survived, and have gotten healthier.
>
> Jay
Posted by g_g_g_unit on October 22, 2010, at 2:14:56
In reply to Re: intellegence vs. motivation » g_g_g_unit, posted by Maxime on October 21, 2010, at 11:16:22
> I like how you put that. That's how I feel about the Adderall I take.Well, it's a bizarre situation because I get so used to being told that what I'm experiencing is anxiety or a crisis of confidence, despite having lived the first 22 years of my life as a highly intelligent person. For the past 3 years, I'd become convinced that I'd just dreamed that life, or that maybe I was always like this and just privately exaggerating my abilities. The first time I tried dex, it was like a light switch going off: I remembered who I was.
Posted by Brainbeard on October 23, 2010, at 17:56:21
In reply to Re: intellegence vs. motivation » Maxime, posted by g_g_g_unit on October 22, 2010, at 2:14:56
Dex has given me moments of refinding deeply buried enthusiasm in a collision of intellectual endeavour and passionate emotions.
It's funny that whereas methylphenidate (MPH - Concerta, Ritalin) seems to kill any religious sensitivity, Dex seems to increase it.
I have told my p-doc how I got some Dex from a friend overseas and tried it, to find that it not only gives me focus and motivation, but also helps me to stand above my OCD, tinnitus, little pains and fears. He reacted by saying that dex would sure be an option in his treatment. Not wanting you to eat your heart out, g_g_g.. He may still crawl back, and he wants me stabilized on the friggin' clomipramine first anyway. Plus I have been as stupid as suggesting Abilify myself pver Dex.. I hope to correct that tragic failure next time I see him.
Posted by g_g_g_unit on October 24, 2010, at 8:04:33
In reply to They Stole My Brain And Put It In A Toaster, posted by Brainbeard on October 23, 2010, at 17:56:21
> Dex has given me moments of refinding deeply buried enthusiasm in a collision of intellectual endeavour and passionate emotions.
>
> It's funny that whereas methylphenidate (MPH - Concerta, Ritalin) seems to kill any religious sensitivity, Dex seems to increase it.
>
> I have told my p-doc how I got some Dex from a friend overseas and tried it, to find that it not only gives me focus and motivation, but also helps me to stand above my OCD, tinnitus, little pains and fears. He reacted by saying that dex would sure be an option in his treatment. Not wanting you to eat your heart out, g_g_g.. He may still crawl back, and he wants me stabilized on the friggin' clomipramine first anyway. Plus I have been as stupid as suggesting Abilify myself pver Dex.. I hope to correct that tragic failure next time I see him.Well, don't sweat about eating hearts out and whatnot. My GP has referred me to a new psychiatrist who deals with ADD comorbid with anxiety issues, and supposedly has no qualms about stimulant therapy.
So you've had a change of heart on Abilify? As much as my psychologist tries to convince me otherwise, I somehow doubt it would be very effective for concentration issues outside of psychosis/bipolar. What's more, I'm specifically concerned about improving the *quality* of my concentration, which I find Dexedrine addresses.
Yeah, Ritalin felt quite abrasive to me. Dexedrine feels a lot more 'natural'. Both make me feel introverted and a little anhedonic, though that might be an ADD thing, since I'm naturally too impulsive for my own good.
I wish clomipramine would work for me, but it just doesn't seem to be doing much of anything for my anxiety, and the movement sfx won't go away. I've started tapering off. .
Posted by linkadge on October 24, 2010, at 12:51:59
In reply to They Stole My Brain And Put It In A Toaster, posted by Brainbeard on October 23, 2010, at 17:56:21
Thats funny that you said dexidrine has enhanced religious sensitivity.
I feel the same way. Ritalin seems to act more like a mood stabilizer for me. Amphetamine has be "believing" in things. Mind you, amphetamine really distorts my thinking (psychotic sometimes) wherase ritalin almost seems to be an AP for me.
Linkadge
Posted by maxime on October 24, 2010, at 14:36:05
In reply to Re: They Stole My Brain And Put It In A Toaster » Brainbeard, posted by linkadge on October 24, 2010, at 12:51:59
I find that Adderall is helping my mood as well. It calms me, and it allows me to focus better. Without the Adderall my thoughts are all over the place.
Ritalin was the worse med for me because it would wear off suddenly and I would become a monster.
Dexedrine was okay but because I had to take it twice a day I started abusing is.
Adderall XR is one dosage in the morning and I don't even think about having it in myself. I don't feel like abusing it because it doesn't make me feel "zippy" the way the Dex did.
Thank goodness we have so many different ones to try!
Posted by g_g_g_unit on October 24, 2010, at 20:42:56
In reply to Re: They Stole My Brain And Put It In A Toaster » Brainbeard, posted by linkadge on October 24, 2010, at 12:51:59
Mind you, amphetamine really distorts my thinking (psychotic sometimes) wherase ritalin almost seems to be an AP for me.
>
> LinkadgeSorry if this is a dumb (almost to the point of ironic) question, but what does psychotic thinking on stims look like?
Posted by Brainbeard on October 25, 2010, at 7:24:42
In reply to Re: They Stole My Brain And Put It In A Toaster » Brainbeard, posted by linkadge on October 24, 2010, at 12:51:59
> Thats funny that you said dexidrine has enhanced religious sensitivity.
>Another thing, which, I think, I haven't mentioned here before, is that Ritalin/Concerta triggers homosexual ideation in me. Very peculiar. I am not gay, and it's not something I am particularly happy about.
Posted by Brainbeard on October 25, 2010, at 7:26:41
In reply to Re: They Stole My Brain And Put It In A Toaster, posted by Brainbeard on October 25, 2010, at 7:24:42
> Another thing, which, I think, I haven't mentioned here before, is that Ritalin/Concerta triggers homosexual ideation in me. Very peculiar. I am not gay, and it's not something I am particularly happy about.To clarify further: of course I have homosexual tendencies to begin with, it's just that they're being triggered by methylphenidate. Smoking pot triggers them
likewise, and I find the methylphenidate rush akin to the marijuana high.
Posted by ed_uk2010 on October 25, 2010, at 13:57:48
In reply to Re: They Stole My Brain And Put It In A Toaster, posted by Brainbeard on October 25, 2010, at 7:24:42
>Ritalin/Concerta triggers homosexual ideation in me.
'Homosexual ideation' hahaha. I suppose that's one way of putting it. Very clinical. It reminds me of the drama surrounding Prozac triggering suicidal ideation.
Posted by Brainbeard on October 25, 2010, at 14:38:13
In reply to Re: They Stole My Brain And Put It In A Toaster » Brainbeard, posted by ed_uk2010 on October 25, 2010, at 13:57:48
> 'Homosexual ideation' hahaha. I suppose that's one way of putting it. Very clinical. It reminds me of the drama surrounding Prozac triggering suicidal ideation.
>I was thinking about putting 'ideation' between brackets, but thought that would spoil the humour.
Posted by sukarno on October 27, 2010, at 19:35:28
In reply to psychiatry is a joked dreamed up by Kafka +Abilify, posted by g_g_g_unit on October 21, 2010, at 2:52:11
> So I've been seeing this GP who strongly advocates ADD recognition, and who I advised that I experiment with the left-over dexedrine I had over this past week.
>
> "Awakening" wouldn't really be too strong a word to describe my experience (as with all stimulants) - I rapidly transform from a motivationless, foggy, intellectually wanting patient into a bright, dynamic, high-functioning individual. I've struggled to finish a single book over the past year and a half, yet am able to bound through and process information on stimulants to a degree I've never experienced before. Despite being academically gifted, I've never been able to read for longer than 45 minutes at a time, but can read for two hours+ with ease on stimulants.
>
> So I tell my psychiatrist this today, and her response is that "stimulants improve everyone's intelligence .. that's why they're abused in America". She then writes me a script for abilify and says that that should help fix my concentration problems.
>
> I smiled, nodded politely and left, and then came home and felt like putting my fist through the wall.
>
> Is that an extreme reaction? It seems like every step I take forwards, I'm being forced back three. Every door I open leads to a brick wall.
>
> Do I try the abilify? I'm wound up and unable to sleep on the clomipramine, so is it just gonna make things worse? I don't wanna take it out of spite, but I know that's an immature stance.
>
> I'm seeing the ADD guy again tomorrow because he's looking at arranging a referral treatment for me. I think that if the next psychiatrist I meet doesn't wanna listen to me, then I give up. After 8+ psychiatrists, I have not met a single one who offers me more than lip service, who seems to care about the wellbeing of me as a person, who will listen, pay attention, or exhibit anything resembling a soul.
>
>
>
>If you live in or near Atlanta (or are willing to travel that far), Dr. Darvin Hege, M.D. is a psychiatrist who prescribes Ritalin, Vyvanse and other stimulants for ADD. He considers himself to be an ADD specialist (or certainly gives that impression as his website has an "adult ADD" questionnaire consisting of several questions). I failed all the questions, but I have panic disorder and heart palpitations so I think stimulants are contraindicated for me. Even caffeine, a weak stimulant by comparison, sends my heart out of rhythm sometimes.
Posted by sukarno on October 27, 2010, at 19:38:19
In reply to Re: psychiatry is a joked dreamed up by Kafka +Abilify » g_g_g_unit, posted by sukarno on October 27, 2010, at 19:35:28
Dr. Darvin Hege, M.D.
2150-P Peachford Road
Atlanta, GA 30338, United States
(770) 458-0007
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