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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by KarenB on March 28, 2000, at 21:49:13
Dear Sarah, Carol Ann and everyone else,
After being treated haphazardly for depression most of my adult life, with every SSRI imaginable to no avail, I was diagnosed Bipolar II almost two years ago. I was living in the Philippines and ended up on Amineptine (anti-depressant of the mood-brightening, psycho-stimulant variety, not available in the US) and an antipsychotic, Sulpiride, for my physical symptoms of apathy and fatigue. Well, the combination worked and I was sane, focused and happy for the last 1 1/2 years, until my return to the US and discontinuation of Amineptine by the manufacturer.
I am now going through the grueling, hideous task of finding new meds. Lithium made me unbearably nauseous. Serzone made me weird, socially inhibited, on the verge of tears and too sleepy and apathetic to go on with life. I am now on Nortriptyline and just feel a little revved up and anxious - but not good. I am, at this moment, really hurting and frustrated - BUT... I am reading with greater and greater interest, your posts on ADD.
What I am getting at is that I believe I may have been wrongly diagnosed with Bipolar II, as my only episodes of mania consist of extreme irritability, irrational outbursts of anger and saying inappropriate or mildly shocking things. My depression consists of not having enough energy to be alive and moving, being unable to focus and being ineffective and scattered. The frustration of this condition has made me on several occasions in my life, suicidal. Or, shall I say, entertaining suicidal ideology on a regular basis.
I feel like I am rambling here but what I want to know, especially from you, Sarah and Carol Ann is this: What symptoms did you have that shifted you from a Bipolar diagnosis, to ADD? Can you elaborate on that a little for me?
I find it interesting that the only antidepressant that has ever worked for me is described as a "psychostimulant," possibly the reason it is not accepted in the US, as it reportedly has "potential for abuse." Well, I never abused it or ever had the desire to. I simply made me feel focused and NORMAL, for the first time in my life. I am 39.
Could it be that I am ADD? I know that I am not hyperactive but from what I have read, that is not a requirement. Looking back to my days in school, I can see that with an I.Q. of 150, I only did moderately well in school, almost failing Algebra, because I couldn't stay focused on the problems and formulas. I remember struggling with that. And, the fact that I can write music even now from what I am "hearing" in my mind but could never learn to read music - same reason - inability to stay focused on the task. I could go on and on but...
I'm kind of excited - does this mean I may be able to get well?
Tell me what you think about this. I'm eagerly looking forward to your input.
Karen in Denver, CO
Posted by CarolAnn on March 29, 2000, at 17:18:40
In reply to ADD - Sarah, Carol Ann and others..., posted by KarenB on March 28, 2000, at 21:49:13
Dear Karen, boy I could have written your letter about myself! My depression symptoms are exactly the same as yours. I would say that you are very probably ADD. Did you know that there is now an "official" diagnosis called ADD/without hyperactivity? This would also explain some of your fatigue and low motivation, as it does mine. As to the Bi-polar question, I'm not sure...I do think it is possible that the symptoms are related to the ADD, particularly the thing about blurting out inappropriate things(one of the "signs" of ADD). Also, the fact that your symptoms go back to school days (high intelligance, mediocre grades)would be a specific indication of ADD w/o hyperactivity.
So, my suggestion is find a good psychiatrist and explain your situation, even if he doesn't subscribe to the ADD theory(but I think he will), it is very common (according to my Psychiatrist) to treat our type of depression(fatigue,ect.) with a combination of anti-depressants and psycho-stimulants. I am currently taking 200mgs. of Wellbutrin twice a day, 20mgs. of Celexa once, and 10 mgs. of Adderall(stimulant) three times per day. I have seen some improvement, particularly on the Adderall(for the ADD, but originally prescribed for my excessive fatigue). But, not as much improvement as I would like, so just today I was put up another 10mgs. of Celexa, for a total of 30 mgs., which I take early evening. Sorry this is so long, but hope you find it helpful. Good luck! CarolAnn
Posted by KarenB on March 29, 2000, at 17:57:29
In reply to Re: ADD - to KarenB (kind of long reply), posted by CarolAnn on March 29, 2000, at 17:18:40
Carol Ann,
If I am ADD, it would certainly make sense of so much of my life. Like when my mother was asked to remove me from the Brownies troop in second grade for not being able to sit still for the activities and being "disruptive." And the way my husband always says, "Don't forget why you're in there," as I walk into the grocery store and that he always says I "have no concept of real time." He's a great guy and he's not being insulting, it's just the truth. I can get overwhelmed in my own home, darting from one half finished task to another, getting distracted and going to something else.
What is up with the depression? Is this part of the disorder or a separate problem altogether? What do they call your diagnoses - ADD with dysthymia or major depression or just ADD?
Without your meds, do you feel as if you could just sleep forever?
I see my pdoc tomorrow and will discuss this with him. This will be the telling appointment, as to whether I will keep him or not. He has never really asked anything about me personally and seems emotionally unresponsive. He may not be a bad doctor, I just feel no connection with him whatsoever and connection is just not one of my problems. Hey, people who don't know me that well would say I'd pass for normal:) Hee Hee...
Thanks so much for your response. It helped a lot.
This board is great isn't it? I just discovered it a couple of weeks ago as I was researching meds.
Karen
Posted by Chris A. on March 30, 2000, at 1:25:57
In reply to ADD - Sarah, Carol Ann and others..., posted by KarenB on March 28, 2000, at 21:49:13
Karen,
What about asking your pDoc for a consult with one of the experts at UCHSC there to help you sort out what is going on? I may not be back to my computer for a while, so will give you a couple of names. I drive 250 miles one way for an opinion from these docs every once in a while. Steven Dubovsky and Jay Carlson. Dr. Dubovsky only consults, since as he is the department head. It usually takes a couple of months to get an appointment. There is always the possibility of a dual type diagnosis of ADD/Bipolar. Those two can be difficult to differentiate. They say the ADD kid drives off the road because they're not paying attention. The one with bipolar drives off because they don't care whether they live or die. I have an ADHD family member and have bipolar myself. Good docs are happy to help with a consult, particulary when the diagnosis is in question.From the other side of the big hill,
Chris A.
Posted by Elena Think you have ADD? READ THIS on March 30, 2000, at 8:23:25
In reply to Re: ADD - to KarenB (kind of long reply), posted by CarolAnn on March 29, 2000, at 17:18:40
>Karen--with an IQ of 150 you owe it to yourself to go to borntoexplore.org. Follow the links. I suspect you may be a gifted woman suffering from depression for really good reasons. Please e-mail me when you've done this. And that goes for anyone else out there too. I am a journalist and I am DETERMINED to write about this from the POV of those of us who've been diagnosed with a "disorder" when what we really are is too smart for the status quo.
ElenaDear Karen, boy I could have written your letter about myself! My depression symptoms are exactly the same as yours. I would say that you are very probably ADD. Did you know that there is now an "official" diagnosis called ADD/without hyperactivity? This would also explain some of your fatigue and low motivation, as it does mine. As to the Bi-polar question, I'm not sure...I do think it is possible that the symptoms are related to the ADD, particularly the thing about blurting out inappropriate things(one of the "signs" of ADD). Also, the fact that your symptoms go back to school days (high intelligance, mediocre grades)would be a specific indication of ADD w/o hyperactivity.
> So, my suggestion is find a good psychiatrist and explain your situation, even if he doesn't subscribe to the ADD theory(but I think he will), it is very common (according to my Psychiatrist) to treat our type of depression(fatigue,ect.) with a combination of anti-depressants and psycho-stimulants. I am currently taking 200mgs. of Wellbutrin twice a day, 20mgs. of Celexa once, and 10 mgs. of Adderall(stimulant) three times per day. I have seen some improvement, particularly on the Adderall(for the ADD, but originally prescribed for my excessive fatigue). But, not as much improvement as I would like, so just today I was put up another 10mgs. of Celexa, for a total of 30 mgs., which I take early evening. Sorry this is so long, but hope you find it helpful. Good luck! CarolAnn
Posted by Sorry--borntoexplore.org. on March 30, 2000, at 10:01:33
In reply to Re: ADD - to KarenB (kind of long reply), posted by Elena Think you have ADD? READ THIS on March 30, 2000, at 8:23:25
> >Karen--with an IQ of 150 you owe it to yourself to go to borntoexplore.org Follow the links. I suspect you may be a gifted woman suffering from depression for really good reasons. Please e-mail me when you've done this. And that goes for anyone else out there too. I am a journalist and I am DETERMINED to write about this from the POV of those of us who've been diagnosed with a "disorder" when what we really are is too smart for the status quo.
> Elena
>
>
>
>
>
> Dear Karen, boy I could have written your letter about myself! My depression symptoms are exactly the same as yours. I would say that you are very probably ADD. Did you know that there is now an "official" diagnosis called ADD/without hyperactivity? This would also explain some of your fatigue and low motivation, as it does mine. As to the Bi-polar question, I'm not sure...I do think it is possible that the symptoms are related to the ADD, particularly the thing about blurting out inappropriate things(one of the "signs" of ADD). Also, the fact that your symptoms go back to school days (high intelligance, mediocre grades)would be a specific indication of ADD w/o hyperactivity.
> > So, my suggestion is find a good psychiatrist and explain your situation, even if he doesn't subscribe to the ADD theory(but I think he will), it is very common (according to my Psychiatrist) to treat our type of depression(fatigue,ect.) with a combination of anti-depressants and psycho-stimulants. I am currently taking 200mgs. of Wellbutrin twice a day, 20mgs. of Celexa once, and 10 mgs. of Adderall(stimulant) three times per day. I have seen some improvement, particularly on the Adderall(for the ADD, but originally prescribed for my excessive fatigue). But, not as much improvement as I would like, so just today I was put up another 10mgs. of Celexa, for a total of 30 mgs., which I take early evening. Sorry this is so long, but hope you find it helpful. Good luck! CarolAnn
Posted by CarolAnn on March 30, 2000, at 10:35:23
In reply to Re: ADD - CarolAnn, posted by KarenB on March 29, 2000, at 17:57:29
Karen, the depression could be either an off-shoot of the ADD, or a whole other problem, or both. With me, the depression diagnosis came first, mainly because I had never even considered ADD, having always associated it with hyper-activity(I have never had even one second of hyper-activity in my life!). It wasn't until I read(actually on this board) that there is such a thing as ADD w/o hyperactivity, that I started researching and found all my corresponding symptoms. I'm not sure exactly what my "official" diagnosis would be. I think that my depression springs from both a genetic predisposition (chemical imbalance in the brain) and also from suffering *undiagnosed* ADD for my whole life(I just found out a few months ago). From what you have described, I think that your case is probably the same as mine. Kind of: depression and also ADD *caused* depression. In answer to your "sleep" question, not only do I want to sleep all the time without medication, I have actually reached such lows that I was seriously considering suicide just to "end the tiredness!".
You definitly want to find a Pdoc you can work with, mine is the second after a disaster of unhelpfulness masquerading as a Pdoc!
You know, it's amazing how much you and I have in common. Nobody ever thinks that I am anything but completely normal, even people who've known me for years are totally surprised when I tell them what I've been going through all this time. Good luck with your Pdoc appt., I'll be rooting for you! Let me know how it goes! CarolAnn
Posted by Sarah on March 30, 2000, at 12:34:12
In reply to ADD - Sarah, Carol Ann and others..., posted by KarenB on March 28, 2000, at 21:49:13
Hey, Karen, I would certainly have a talk with the doc over this one! When I was finally treated for my ADD, I didn't need AD's anymore. My anxiety and depression went away almost immediately! When I was on AD's, the only one that really worked was Elavil. It is actually quite sedating, but it worked for the depression that has turned out to be a by product of the ADD. I also have an above average IQ,(143), but had a horrible time in school. I never had the hyperactivity, just a daydreamy, non homework doing little girl. I was pretty much over looked as an underachiever. I also had some learning disabilities with it all. Took me forever to learn to read and I still can't spell worth a damn despite the intelligence. I do love reading though. I was put on Adderall about three months ago and it has totally changed my life! My house is organized and I finally get things finished! Such a good feeling! Again, it is something I would certainly take up with the doc! Hope I have helped... Sorry it took me so long to get back to you, got a house full of sickies! Oh, almost forgot, yes, I could sleep all day without the meds!
Posted by Sarah on March 30, 2000, at 12:47:08
In reply to Re: ADD - to KarenB (kind of long reply), posted by Elena Think you have ADD? READ THIS on March 30, 2000, at 8:23:25
Elena, I checked out that site... Really a good one! It is so nice to see a site on the positive aspects of ADD! I have always felt that my ADD was more of a blessing than a curse! I have had an adventurous, interesting life because of it! Granted, I have done the impulsive, crazy-stupid things, but all in all, the positives outweigh the negatives... Thaks for the link! Sarah...
Posted by KarenB on March 31, 2000, at 12:18:56
In reply to Re: ADD - KarenB, posted by CarolAnn on March 30, 2000, at 10:35:23
Hi Guys!
I went to my pdoc yesterday and told him what I suspected about my diagnoses of Bipolar II actually being ADD with depression. He agreed that it was a strong possibility, especially since the only antidepressant that has ever worked for me is a psychostimulant (Amineptine), a dopamine uptake blocker. The same type of medication is used to treat ADD. Mood stabilizers have also failed to work or made me ill.
I am giving serious re-consideration to certain events and problems in my life, especially during school and concerning jobs. They seem to stem from my inability to concentrate and a tendency to become easily bored. My depression may be a result of years of the disorder or a condition all on it's own, I'm not sure. Some of you who were also misdiagnosed say that once on the ADD drug, the antidepressants were no longer necessary. I hope that will be true for me as well.
Doc started me on a low dose of Ritalin, to be increased early next week if all goes well. I am still reluctantly taking the Nortriptyline as an AD but will try to lower the dosage down as the Ritalin starts working, and see what happens.
Thank you all so much for your input and help on this!
Karen
Posted by michael on March 31, 2000, at 18:21:25
In reply to Re: ADD (pdoc update), posted by KarenB on March 31, 2000, at 12:18:56
> Hi Guys!
>
> I went to my pdoc yesterday and told him what I suspected about my diagnoses of Bipolar II actually being ADD with depression. He agreed that it was a strong possibility, especially since the only antidepressant that has ever worked for me is a psychostimulant (Amineptine), a dopamine uptake blocker. The same type of medication is used to treat ADD. Mood stabilizers have also failed to work or made me ill.
>
> I am giving serious re-consideration to certain events and problems in my life, especially during school and concerning jobs. They seem to stem from my inability to concentrate and a tendency to become easily bored. My depression may be a result of years of the disorder or a condition all on it's own, I'm not sure. Some of you who were also misdiagnosed say that once on the ADD drug, the antidepressants were no longer necessary. I hope that will be true for me as well.
>
> Doc started me on a low dose of Ritalin, to be increased early next week if all goes well. I am still reluctantly taking the Nortriptyline as an AD but will try to lower the dosage down as the Ritalin starts working, and see what happens.
>
> Thank you all so much for your input and help on this!
>
> Karen
Hello -There sounds to be a good deal of overlap between what you've been discussing, and dysthymia...?
Especially the fatigue, difficulty w/concentration or focus, sleeping...
I'm just wondering what would be specific to one or the other?
I mentioned a while back that I've used ephedrine in the past (self-medicating), which helped w/the lack of energy as well as the concentration, getting things done and organized, etc. I mention it again because I recently read that what it does is release the norepinephrine that is stored - it's a CNS stimulant. (at the time, I just knew that it made me a LOT more productive and able to focus)
Anyway, Just wondering, given my response to the ephedrine (a stimulant), does that suggest ADD as a possibility? I didn't have much trouble in school (ability to focus, study, learn, etc), but I sure would now!
Or would dysthymia (which is what my diagnosis is) be more accurate/probable - and my response to the stimulants is just what happens when you take stimulants?
Hope that wasn't too disorganized/incoherent.
Any opinions on whether stim's vs. AD's might be more appropriate, or more likely to help in such a case?
(btw, tried wellbutrin - nothing; effexor w & w/o the wellbutrin - made me sleepy; and now a few weeks on prozac w/the wellbutrin - nothing)
Posted by Sarah on March 31, 2000, at 21:51:14
In reply to ADD, depression, dysthymia, posted by michael on March 31, 2000, at 18:21:25
Michael... Most ppl are born with ADD, it can be accuired, but usually with some sort of head trauma. I am by no means a pro at this, but I wouldn't think of it as ADD. It does mimic bi polar, and at times good ole depression. (depression goes along with most cases of untreated ADD, though...) I would certainly bring it up with the Doc, though. I have also medicated with ephedra in the past, all I can say is it is a sorry excuse for a stimulant and I always felt very depressed when I would finally crash from it. I don't have that problem with Adderall. I always feel fine when it wears off at the end of the day, and have a good nights sleep. Anyway, I would have a talk with my doc... Hope I have helped...
Sarah
Posted by Sarah on March 31, 2000, at 21:56:05
In reply to Re: ADD (pdoc update), posted by KarenB on March 31, 2000, at 12:18:56
Hi, Karen... Wow! Glad to hear you are giving the ADD thing a whirl! I hope the Ritalin helps, I know the Adderall has helped me! From what I have learned, the ritalin hits you faster and then wears off faster than Adderall. My shrink hardly uses it anymore. My daughter is on it (ritalin) for her ADHD and it works wonders for her... We were thinking of changing her to Adderall, but we decided, 'if it aint broke, don't fix it'! Keep us up to date on it all!
Sarah
Posted by michael on April 1, 2000, at 0:05:52
In reply to Re: ADD, depression, dysthymia, posted by Sarah on March 31, 2000, at 21:51:14
> Michael... Most ppl are born with ADD, it can be accuired, but usually with some sort of head trauma. I am by no means a pro at this, but I wouldn't think of it as ADD. It does mimic bi polar, and at times good ole depression. (depression goes along with most cases of untreated ADD, though...) I would certainly bring it up with the Doc, though. I have also medicated with ephedra in the past, all I can say is it is a sorry excuse for a stimulant and I always felt very depressed when I would finally crash from it. I don't have that problem with Adderall. I always feel fine when it wears off at the end of the day, and have a good nights sleep. Anyway, I would have a talk with my doc... Hope I have helped...
> Sarah
Hey Sarah,Thanks for the reply. I kind of didn't think the ADD thing was the best fit (not that I know which of the names/labels is the best fit...)
Anyway, I definitely plan to mention it to my doc (new doc for me - 2nd visit), although I don't know her well yet, I get the feeling she's pretty conservative... (ie: "stilmulant evasive")
As for the ephedra - not sure, but I think that ephedrine is like "refined ephedra", for lack or a more apporpriate term... I know a number of states have made it no longer available over the counter. Although I've never experienced the crash... For me, it's always been like a couple cups of coffee is supposed to be, w/o being so wired...
Anyway, thanks again for the feedback, I appreciate it.
michael
Posted by KarenB on April 1, 2000, at 16:55:31
In reply to ADD, depression, dysthymia, posted by michael on March 31, 2000, at 18:21:25
Michael,
True ADD, according to what I am reading, shows up in symptoms prior to age seven, or sometimes following a head injury. I could say I qualify for both.
Karen
This is the end of the thread.
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