68 replies to this topic

[z4l]

Hi everyone,

I'm more of a lurker here but I'm getting kind of desperate for some answers right now. I'm ready to try once again the great minefield of ADHD medications. 

 

Here's the rundown:

 

1. I'm 32/F and reasonably healthy. I used to exercise and eat better but lately my depression and ADHD has made it exceedingly difficult to go to the gym. Basically I'm stuck in a rut.

 

2. I'm failing at freelancing, which requires me to actually make work for myself in order to make money. I can't rely on a paycheque to arrive every 2 weeks. I have to create my own work by thinking up ideas, pitching, and executing. This is hard to do when your ADHD/anxiety/dysthymia is affecting you.

 

3. I am currently taking Selegiline - 5mg oral tablets. I was on the liquid drops before, and I was doing much, much better on that (more on that in a sec). In fact I was starting to get a REAL handle of things in the spring and summer and I thought I had it all under control and I was finally ready to freelance. In the past few months though, I've been a little less regular in taking the pills, and this is possibly adding to my problems. Same goes for the less efficient absorption. I'm taking it with my natural almond-butter breakfast, as well as...

 

4. Three fish-oil caps, daily. Jamieson Natural Sources, "Salmon & Fish Oils." Combined I get about 540 mg of EPA and 360 mg of DHA. 

 

5. I don't take much else. In my desperation in the last few days I started taking ALCAR, 1g a day. Also popped an ashwagandha which I might supplement with again, but only 2-3x a week. This drug cleared out every iota of anxiety in my body but gave me terrible acne to the point that I had to stop. I have a hormonal acne problem which I try to handle using top-of-the-line skincare products and I'm usually pretty good at keeping it under control, but the ash messed it up.

 

6. I do have hormonal problems, in that I've had ovarian cysts issues (requiring surgery) and very terrible menstrual symptoms. Daily exercise helps with this, and before I quit my day job I would power walk to work. An easy way to get some moderate cardio.

 

7. I can't force myself to go to a gym even though my condo has a free one, and there are even free bootcamp classes available to me (at inconvenient times, but still). I was better at going to these during the summer.

 

7.  It's hard for me to tell if I have any will power over the things that I do. I've been reliant for so long on external structures to keep me in line (e.g. getting exercise by simply walking to work, because I have to go to work, right?) and I can convincingly come off as a very competent person, even though to my friends, meeting them for coffee or a drink or something may be the only thing that actually gets me out of bed and showered and dressed and putting on makeup. Essentially, taking care of myself. I have struggled to change this for YEARS through therapy but I feel like I've made so little progress that it doesn't count anymore. I'm also not sure to what extent my success earlier in the year had to do with a pre-existing external structure (aka my job) was helping me keep in line OR how much of it was the Selegiline. I like to think it was the latter because before that, despite having a job, I wasn't doing as well.

 

8. I do not want to go back to a day job. I love freelancing, I just need to be able to have the right attitude to actually get shit done. I've worked really really hard to make freelancing my reality. I'm not going to sound the suicide alarm here, but if I fail at this again I really have no idea what I would do in life anymore. Sitting behind a desk following orders doing work that doesn't interest me kills my soul.

 

9. I'm having a hard time establishing daily routines. I try. I want to eat breakfast, meditate and shower in less than an hour. Currently it takes me 3, and you know I'm trying because I actually DO get around to meditating at some point! On days where I'm less than trying, I won't even consider meditating.

 

10. My therapist in my hometown was nice enough to try a few different meds for me for my depression/anxiety and ADHD. I've tried Ritalin and Concerta for ADHD and I couldn't handle the speedy feeling, crash and burn, and the exhaustion from having that much stimulation in my body long term. My anxiety is so bad that I had to quit drinking coffee, so stims are OUT. Not interested in Adderall or Vyvanse or anything of that sort. As for depression, I've tried SSRIs and SNRIs and the latter actually seemed to be helping, but the serotonin always kills my libido to the point that it's a deal-breaker.

 

11. I mention my hometown because my current therapist may or may not be able to prescribe meds. He acknowledges that I have ADHD based on a behavioural checklist but here in Canada, super-official ADHD testing can cost thousands of dollars and I don't need someone to tell me something I already know. The fact that I've had a doctor work with me to try meds tells me that she could see the symptoms and agreed to try meds. Not sure if I will have the same reaction from my current therapist. I'll have to wait and see.

 

12. One of my biggest problems when I'm having intense ADHD problems is that I can't do mentally taxing work. Well, that's what freelancing consists of. I have to research, read, keep up on trends, come up with ideas, and write. All mentally taxing work. And I'm INTERESTED in doing this stuff generally, but when I have trouble focusing on something I instead hyperfocus on all the wrong things. Perseveration messes me up big time.

 

11. Things that seem to help:

- Strenuous exercise every day, if I could only commit to it

- Smoking, obviously no longer doing that but it helped a bit in my last school year

- Selegiline - I'm thinking maybe the MAO-B connection from both smoking and this is a key. Maybe MAO-B inhibition helps regulate my neurotransmitters, or maybe ensure that enough of them stick around long enough 

- Regular routines, though I'm not sure without medication or external structures I can actually do it

 

 

12. Things that don't work:

- Memory training (can't commit to it long enough, and I don't think it works anyway)

- Stimulant ADHD medication (awful side effects, anxiety inducing)

- Coffee (anxiety inducing)

- Racetams (did nothing)

- Noopept (made me really tired)

- Supplementing with B complex, Zinc, Mag, etc (did very little)

- Cannabis (I only mention this because someone suggested it in a thread once which made me laugh... I barely ever smoke because it makes me feel like I have dementia for 2 days after)

 

13. What I'd like to try are essentially the 2 remaining ADHD meds that are non-stimulants:

 

a) Strattera. I know it causes a lot of nasty side effects but they're usually transient if you can make it past the first month. I'm hoping I don't get any of the sexual side effects, which appears to affect men more than women anyway. Since I believe SNRIs were somewhat helpful in the short time I was on them, I'm willing to give this a go.

 

b)  Guanfacine. My only worry with this is that I used to have hypotension problems in the past so I don't need anything to lower my BP even further. Selegiline may have increased it to a more normal rate, I don't know (and yes, I should be monitoring it! You're right. I will get it checked out today).

 

c) Return to Selegiline liquid drops, 5mg a day. I just don't know if this will be enough anymore. I want to try something stronger.

 

Is it possible to take Guanfacine and Selegiline together? I know the latter and Strattera would not get along.

 

If you have any other suggestions or advice, please let me know. I'm getting desperate. As for which of the 2 meds I'd try first... I don't even know how to choose. My doctor may tell me only one is available, and we'll also have to see what is covered by my health insurance.

 

Thanks for any input you can provide... and sorry for the long post. 

[Mind_Paralysis]

Have you considered that you don't have ADHD at all, but another Neurodevelopmental Disorder? The fact that you respond badly to stimulants implies this. Your personality mirrors my own to some extent as well - and I have disorder SCT - Sluggish Cognitive Tempo.

 

The Dysthymia and Anxiety implies it as well - I have those too - almost EVERY SCT-er has them. (however, the dysthymia may not actually fully BE dysthymia, but rather the signs of low Norepinephrinergic activity, which is at the root of the disorder)

 

Read about SCT here:

 

https://en.wikipedia...tempo#Treatment

 

Why I mention it being an NE-disorder, as opposed to a DA-disorder like ADHD, is because the symptoms mirrors damage to the Parietal and other networks at the back of the head, and guess what? A recent fMRI-study revealed that people with SCT-symptoms have markedly decreased activity in the SPL - Superior Parietal Lobe.

 

If you identify with SCT, then there's a good chance that REBOXETINE could help - that, or Atomoxetine. (strattera)

 

I recommend you try Reboxetine first, ask for it as a treatment against your Dysthymia. Reason I recommend it first, is because Atomoxetine has much worse side-effects than Reboxetine - it turns into a so-called opiate KAPPA-antagonist inside your body, and Kapp-ANTagonism, the exact opposite effect, has recently been discovered and trialled as a very, very effective anxiolytic and anti-depressant - it then stands to reason that Kappa-agonism would be bad...

 

Kappa are the receptors which control Punishment-response in the brain, and when combined with increased NE, then that's a recipe for THE worst side-effect of Atomoxetine: SUICIDAL IDEATION!

 

ATX is infamous for this sid-effect, but the two related compounds - Reboxetine and Viloxazine, also Norepinephrine-Reuptake Inhibitors does NOT produce this to the same extent! This has been a mystery for some time, especially since ATX in theory should be better tolerated, with both light NMDA-antagonistic properties as well as slight Serotonin-reuptake inhibition, but Kappa-agonism now stands as the plausible culprit for the worst side-effects of ATX.

 

So - REBOXETINE.

 

Go get.

 

(me personally, I've had GREAT results from ATX! hardly any side-effects, however, that's also because I DON'T metabolize ATX - I have faulty CYP2D6-enzymes, which means I don't really get any of the suicide-metabolite - it also, alas, means atx is harder to dose, but since I know about it, it's not a problem.)

Edited by Stinkorninjor, 30 December 2016 - 05:13 PM.

[z4l]

Thanks so much for your thoughts Stinkorninjor. I've looked at SCT before and have considered that I may have it to some degree. When I read the symptoms of SCT I do feel like quite a few apply to me, especially the getting lost in thought, trouble staying alert in boring situations (I have fallen asleep during meetings), and having trouble putting thoughts into words. In fact, I sometimes wonder if the reason I went into writing is because sitting down and contemplating my ideas and having the time to phrase them in written form actually helps me realize things as well as feel a sense of accomplishment that I can finally communicate. It's a lot easier for me to do this through writing than talking, because talking requires me to come up with the sentences and words right away. People tell me that I'm a good conversationalist, but I seem to do best in short bursts. I have put a lot of time and energy into learning how to be empathic and a good listener, and sometimes it's a huge huge strain on me. That said, I'm more extroverted than introverted, but I do need a lot of down time as well.

 

I think I may have a bit of ADHD-PI in there too.

 

When I'm exercising regularly and eating healthily, some of the SCT symptoms disappear, especially the energy-related ones. Now that I'm lazier, I'm feeling well, a lot more lethargic. This used to be a huuuuuge problem for me. I would fall asleep in the evenings if the husband threw on a movie. I would get enough sleep. Eat enough food. But I was too sedentary.

 

I really did think that some of the more larger, behavioural kinds of ADHD problems, e.g. my inability to finish things without some external pressure, could be helped through CBT. And while I've made a bit of progress (the fact that I managed to meditate every day for 20 minutes for more than a month is truly an accomplishment), none of them really stack up or start snowballing into more long-form kinds of change. In six months, I'll be interested to know if I kept on that meditating habit. I've definitely already taken breaks more than a couple of times in the past few months since I started doing it more regularly.

 

I'm going to try what you said and ask for Reboxetine and failing that, Strattera. I don't know what to do about the Selegiline though. I'm assuming either RBXT/ATX would be contradicted with selegiline. I'm running out of tablets anyway.

 

And now I'm off to the gym for the first time in days. We'll see how it goes.

 

Here's another thing that gets me, speaking of the gym. Our bootcamp classes work really well for me. Again, it's that external pressure. Someone yelling at me motivates me. I will do a million burpees until I pass out. Me going to the gym alone to do some squats or presses? Hah. I don't push myself as hard. I give up more easily. I take more time. And obviously I then don't feel the burn. I need to feel that strength-training burn in order for it to have a real difference.

 

P.S. The messed-up ordering of my points in my original post is pretty hilarious and just another indication that I have some kind of disorder... Possibly 2. This is why I love editors.

[pseudonamed]

Hey, I am in a similar boat to you, ADHD-pi, f, mid 30s, battling dysthemia, and attempting to freelance (sometimes I wonder if choosing this path is some kind of masochism since I find it so hard to organise but I hate working a 'normal' job).  

 

I had trouble with methylphenidate but I've found if I stick to small doses it does help a bit without all the side effects. SSRIs didn't agree with me.

 

It's always good to have a full blood count and check your thyroid - things like anemia or thyroid issues can affect energy levels, concentration, and cause depressive feelings. Get enough B12 and Vit D, in your diet. 

 

If you can handle some meditation and CBT I would recommend ACT, this is similar to CBT but more inspired by mindfulness. I have found it more helpful than CBT on a personal level because instead of noticing thoughts and turning them around (which can feel false) with ACT you just sort of accept the thoughts as words, and dismiss them. I've been going through a book about ACT and mindfulness called the Happy Trap that's useful so far. Meditation can help, though it's so hard to keep up with a regular practice, when I find it hard I commit to just 5 mins a day, and then if I want to go longer I do but I find it's better to keep the habit up as a tiny habit than to let it go, then it's harder to start again.

 

Same with going to the gym - if you can find a gym buddy to go with you then you'll have more outside motivation. Or someone to go jogging with you, if you'd rather be outside. I definitely feel better all around when I'm working out regularly but once I lose momentum it's hard to get it back. Again I'll try to give myself a tiny goal, like I'll just do 20 mins of cardio, nothing else, if that's what I have to tell myself to get out the door. When I've been really down I just make myself at least do some stretching/yoga. 

 

I have not tried these alternative medications, it was hard enough getting methylphenidate as an adult in the UK. It seemed to be more accepted back when I was in Canada. If you need to get tested you could look for adult ADHD research possibly? I got tested for free in Montreal about a decade ago because they were researching ADHD in adults at the time. But if you have found a sympathetic doctor who doesn't need to see test results then don't lose them - not all doctors are so willing.

 

I have used sulbutiamine and oxiracetam in the past. I have noticed a bit of a boost in motivation from either one but sulbutiamine doesn't really work if you take it daily and oxiracetam seemed subtle and sometimes gave me headaches if I didn't take choline supplements with it. 

 

I have found a SAD bright blue spectrum lamp has been helpful in the winter to help me wake up in the morning and regulate my sleep. Getting regular sleep makes a huge difference for me, I've started using an app on my laptop to make the screen more orange tinted in the evening and try to force myself to not look at screens for at least an hour before bed. Do a bedtime ritual to relax. Then in the morning the bright bluish lamp and morning routine of showering and stretching to get ready.

Otherwise I use a lot of reminders synchronised with my phone and computer. I make sure I take lots of breaks from sitting down too long. I am experimenting with using an app to use the pomodoro method - where you try to focus only on your task for, say, 45 mins, then take a 5 min break, and cycle through that. 

 

Dunno if any of this might help but worth a shot. Good luck! 

[HealthyGrain]

I take Noopept. Before using it I could barely focus one something for 20 minutes. Now I can sit on essays for hours and have more motivation to do work. I also feel like I know what has to change in my life. Stuff that I never thought about like diet. I suddenly feel very motivated to learn about new things and binge watch ted talks and certain documentions. I actually feel guilty when I don't learn something new every day.
However, I feel less hopeful and more pessimistic. Might be because I see things more rational now, than before.
So I don't recommend taking noopept without any kind of mood enhancer. However it might not have that effect on you.
Regards


Sent from my GT-I9301I using Tapatalk

[z4l]

I wanted to check in with you guys and provide an update. I still need some advice.

 

I've been on Strattera for about 7 weeks now. We slowly titrated up to 80mg.

 

It's been quite a journey. Week #3 felt really good. That's when I was still titrating upwards and on 54mg. I'm not sure if that was because I was entering the euphoric honeymoon period of the drug (since it's an NRI it takes some time to kick in) or if it was because I hit my therapeutic dose. I'm HOPING it was because 50~mg is what really works for me.

 

Because 80mg has been so far, a nightmare, despite the titration process that should allow my body to get used to side effects.

 

Even at Week 3, I was having insomnia issues. But the extra energy seemed to make it okay. But that can only last so long. By Week 4-6, the insomnia problems had caught up to me and caused me to feel really tired all the time. Obviously. Any benefits from the drug with regards to focus, attention, energy, motivation, etc, were therefore cancelled out by the sleep deprivation.

 

I started paying more attention to my sleep hygiene, took some valerian root, and I've been able to get mostly on top of that issue.

 

But for the past 2 weeks I've been having much more serious issues with my mood, and I think it may have something to do with the Kappa agonism mentioned earlier in the thread. I don't quite feel suicidal, but I've been seriously depressed. At first I thought it was because I was coming around to all the ways in which my ADHD has held me back in my life, and now that I'm more capable of dealing with the damage, the regret and lost opportunities was wearing me down. And that's an understandable reaction, but the feeling just wouldn't go away no matter how much I tried to reason my way through it. And then I started feeling extremely, extremely hopeless, and angry. Yesterday (I hope anyway) was the peak of that anger. I am also having marital and financial issues right now, and those things are definitely exacerbated by all of this.

 

I'm seeing my therapist on Friday and suggesting we go down to a lower dosage. 

 

The actual positive, ADHD-aiding effects of Strattera, are still there. I can feel it. For a while when the drug blues kicked in, I was still able to get on with things, finish things, plow through work, instead of wallowing and ruminating, which is what I would normally do. That's incredible. I was actually surprised by how well on I could manage given how horrible I felt inside.

 

But these feelings are getting worse and worse, and I've gotten to the point now where I've been taking some time off, just to chill. Do some things that make me happy, and hope it recharges my batteries. As of yesterday I'm also supplementing with 5HTP in case my serotonin is out of wack. I understand Strattera has a slight serotonin effect but I'm wondering if boosting it might help? Or maybe some Ashwagandha would help right now too? 

 

I've started paying more attention to my diet as well, and I'm going to start supplementing with iron and zinc and B vitamins again. 

 

OH! Notable: So despite feeling like total garbage, a couple of days ago, I decided to eat something sugary. True to my ADHD form, I've always needed sugary substance throughout the day to keep me energized. This has been an ongoing problem for me, because I'd actually really like to clean up my diet and everything is easy to do EXCEPT FOR SWEETS. As soon as I started Strattera I've been magically able to not eat sweets. In fact they kinda gross me out! It's unbelievable. But since the drug blues started, I began to crave sweets again. When I gave in, I was again disgusted by the taste, but I finished a small hot chocolate and immediately felt better. Of course, it only lasted a few hours. What does *that* mean? (This is why I actually suspected that maybe my serotonin was out of wack and why I bought some 5HTP.)

 

But now that I re-read this thread I'm thinking it might have something to do with the Kappa too? Or maybe a mix of things at this point.

 

Thanks so much for everyone else who offered their advice. Since the new year, I've been doing an "accountability buddy" program with my sister, who also needed a motivation push. Each day we send each other pictures of our cardio workouts. I've only missed a few days of exercise since January, which is incredible. Unfortunately, I seriously injured my lower back during a bootcamp class, and I'm doing gentle walks for now until my back is better. It's taking a lot longer than I expected, and so that usual neurotransmitter-normalizing effect I get from exercise is not available to me for now.

 

I'm going to look into the ACT book and get back into meditation. I am also starting to take serious steps to jump-start my career. I just can't afford to have this intense depression and anger holding me back now. I literally cannot afford it.

 

Stinkorninjor, would you recommend I switch to Reboxetine if lowering the dose doesn't work? Can the Kappa agonism cause the mood effects I'm experiencing? Would taking a Kappa antagonist help counter the effects of Strattera?

[z4l]

I take Noopept. Before using it I could barely focus one something for 20 minutes. Now I can sit on essays for hours and have more motivation to do work. I also feel like I know what has to change in my life. Stuff that I never thought about like diet. I suddenly feel very motivated to learn about new things and binge watch ted talks and certain documentions. I actually feel guilty when I don't learn something new every day.
However, I feel less hopeful and more pessimistic. Might be because I see things more rational now, than before.
So I don't recommend taking noopept without any kind of mood enhancer. However it might not have that effect on you.
Regards


Sent from my GT-I9301I using Tapatalk

 

Thanks for the suggestion but Noopept wears me out after a few days. For me, it's best as a once in a while energy+focus supplement.

[Mind_Paralysis]

I'll try and reply to this tomorrow, but at the moment I feel like a wreck, side-effects from Atomoxetine (strattera) - today was day 4 on 80 mg, and now I seem to be hitting a bit of a hurdle... noticeably irritable, more anxiety, slight depressive thoughts.

The fatigue was definitely back as well - it should be noted that I took the day off from my adjunctive Armodafinil, in order to make sure I get some proper sleep tonight. I've found that after an initial loading-dose of 75 mg Armodafinil, it's enough to just use 37,5 mg per day, when used for keeping the fatigue and somnolence of Atomoxetine away, but even that starts causing sleep-issues after a few days - powerful stuff!

 

Prior to 80 mg, my thoughts on ATX have been mostly good - actually slightly anxiolytic before this high dose - 80 mg is btw most likely the dosage wherein 5-HT-reuptake starts becoming noticeable for some people, prior to that, the drug is pretty much exclusively an NRI - the anxiety and bad mood may be a result of slightly increased serotonergic activity. That, or I'm finally feeling the effects of the Kappa-agonist metabolite! I've got that error in my CYP2D6-enzyme, which means I hardly even metabolise this stuff, hence, there is very little of the dangerous metabolite in my system, but eventually, after such prolonged use, and such a high dosage, I imagine it finally must be starting to have an effect - time to bring in Tianeptine, I believe!

 

Delta and Mu -agonism should balance the enhanced kappa-activity.

 

Might be a tip btw - buy some Tianeptine to abolish the depressive or anxiogenic effects of Atomoxetine - it should work, if those effects are coming from 5HT and Kappa-agonism - Tianeptine combats both effects.

[z4l]

Thanks Stinkorninjor. How long have you been on Strattera before going up to 80mg?

 

I only went up Week 4 to 80mg (it was 18/36/54mg titration each week until then).

 

Also I miscounted, I'm *just* starting Week 7 now, so technically I've been on Strattera six weeks.

 

[Mind_Paralysis]

TL;DR:

I've been on Strattera in three cycles:

 

1. 14 days - effective dosage 40 mg.

 

2. 34 days - effective dosage varying.

 

3. Currently - 16 days - effective dosage varying.

 

 

I've read your posts now, and some of the side-effects you describe could be from Kappa - the bad mood in particular. It could also just be from too much NE in your system - so try lowering the dosage down to 60 or so mg. The anxiety could be from Serotonin - 5HTP might actually make it worse.

 

Get some Tianeptine, or ask your Dr. to add a real-deal SSRI to deal with any anxiety and depressive mood.

 

 

----------------------------------

Let's see... I really had to dig a bit into my posts here on Longecity to figure out when I started using it...

 

My initial dosing-schedule was from January the 4th to February the 7th, which makes for a total of 34 days of treatment, I believe. I went from 20 mg all the way up to 80 mg during that period - I wasn't on 80 mg for a very long time though, only about 2-3 days, then I went back to 50-60 mg, but did not see any greater benefit for about one weeks treatment at that dosage (previously trialled it at that dose-range for about a week, I believe.)

 

I titrated very gradually, using a combo of 25 mg pills and 10 mg pills to titrate. Since I used a generic, it was not in capsule-form, but in pill-form, hence I was sometimes at many intermediate dosages, by cutting the pills in parts.

 

So it went like this: 30, 35, 40, 45, 50, 60, 65, 70, 80, 60, 50.

 

My maximum tolerable dosage was probably around 60 mg, however, there was also not really much benefit on that dosage either.

 

 

Right now, I'm on my third cycle (the initial was a test-cycle using prescribed 10 mg capsules, going from 10 mg to 40 mg - 40 mg was then the initial effective dosage, using prescribed capsules).

 

The effects are very, very similar to the Indian generic I used - I noticed this after starting at 40 mg again, and have found the effects to be about the same.

 

 

I started the most recent cycle on the 27th of February, and have been using it ever since - that makes for a total of 16 days of treatment. Hmm... I can see how this might be a bit too aggressive of a dosing-schedule - I was able to be aggressive with the dosing thanks to Armodafinil! About 37,5 mg's takes away many of the worst side-effects for me, and becomes synergistic.

 

Currently on 70 mg, at day 16.

 

So far, 70 mg seems more tolerable than 80 mg - however, yesterday I did NOT use Armodafinil, since I felt the need to get in bed early, and that may have to do with my feelings of aggression and anxiety yesterday - I was quite fatigued, most likely from ATX side-effects yesterday, so that may have affected mood.

Edited by Stinkorninjor, 15 March 2017 - 11:16 AM.

[Duchykins]

Memantine is gettng a lot of attention in the medical community for applications in ADHD/ADD, various anxiety disorders, autism, migraine these days.

 

I take memantine 10mg for migraine prophylaxis, and I also take modest doses of methylphenidate (I like to take 10 mg tabs, break them in half and take the halves at 3 hour intervals as long as I remember to, but never more than 30 mg by the end of the day). 

 

I haven't really paid attention to my ADHD-like symptoms... erm, no pun intended, but my executive functioning has improved a little bit as I have managed to establish a steady clock-work morning routine with my pre-breakfast supplements and after-breakfast supplements, which was hard to do a few years ago.  Now I just do it automatically.   But I still hyperfocus on all my favorite bullshit (reading something, usually, acquiring all sorts of obscure information that normal people don't give a shit about, and gawd help anyone who tries to interrupt me when I'm on a roll) and lose track of time.  Similar to you, only external pressures get me to maintain routines.  Only school makes me leave the house and talk to people on a regular basis.  So everything goes to shit between semesters, except my morning and bedtime routines.  And honestly, I think I only have those because of my desperate fear of migraine (and migraineurs need routine).

 

Recommend you stop using makeup, especially if you already know you have hormone imbalances.  The makeup industry has less regulation than the bottled water and dietary supplement industries, and is even less scrupulous than both combined.

 

But the fact that your morning routine takes you 3 hours (task-shifting is a big problem for you), you have a big problem with executive functioning, including self-care ... ?  You might be on the spectrum.  It's entirely possible (and common) to have autism with ADHD features and be misdiagnosed, especially as an adult.  And it's very easy for females to be misdiagnosed as the symptoms of autism are mostly defined in terms of how males exhibit them, and because of doctor gender bias.   The doctors themselves are likelier to diagnose these symptoms in women as anxiety and depression or even a personality disorder, while diagnosing the same symptoms in male patients as autism.  We even know that ER doctors are likelier to misdiagnose women with anxiety attacks when in fact they are having a genuine cardiac event, making women likelier to die after heart attack.

 

The main reason I bring that up is because of how you react to the usual ADHD meds.  You say they are stimulating, and you feel overstimulated on them.  To people with ADHD, these drugs don't feel like stimulants (like caffiene rush, speed, etc).  Nearly everybody else taking these drugs experiences them as classic stimulants.  The ADHD brain is physically different, especially if that person grew up unmedicated.  To people with ADHD and ADD, these drugs level them out and even often make them feel dulled or disconnected (that is the main complaint ADHD patients have about ritalin and adderall). 

 

And since Strattera is not a stim like the other ADHD drugs, your reaction to it can't factor into this that much.

Edited by Duchykins, 16 March 2017 - 05:09 AM.

[jack black]

I agree with Dutchykins, the whole story remind​s me a family member who was officially diagnosed with dyslexia, ADHD, and depression (by different docs), but I suspect she has mild autism/Asperger's combined with social anxiety. She also suffered from low self esteem her entire life. She also poorly responds to ADHD treatments. She got better when I put her on my stack, but sadly she is too disorganized and stubborn to take that huge pile of pills and powders by herself.

Edited by jack black, 16 March 2017 - 12:53 PM.

[jack black]

pointless and timewasting? i see my input is unwanted here. i certainly wasted my time here. over and out.

Edited by jack black, 16 March 2017 - 02:41 PM.

[Finn]

pointless and timewasting? i see my input is unwanted here. i certainly wasted my time here. over and out.

 

Based on her forum profile, that feedback could not have been from the person who started this thread. You can see received and given ratings in profile, the OP hasn't given single "pointless, timewasting" or any other type of negative rating to anyone. Maybe it was from your "forum nemesis"? 

Edited by Finn, 16 March 2017 - 04:23 PM.

[z4l]

Hmm I'm not so sure. I know that autism is different in women, but I've looked at the diagnosis criteria for ASD in the past and it's never quite clicked. I've been very concerned and am quite sensitive on this subject since ADHD also tends to present itself differently in women and I know fully well just how well I've been able to mask my symptoms for so many years and how a big part of that has to do with gender conditioning, as well as having PI.

 

Self-diagnosing is not the same as a full medical assessment, which would be great, but FWIW, I've worked with a psychiatrist+psychologist for four years and he firmly believes I have ADHD. I don't think his experience lies in diagnosing ASD, so sure to your point, it's definitely difficult to find someone who can work past the gender bias. But I tend to be a bit of a hypochondriac w/r/t my mental health and I have researched both of these conditions on my own (yay hyperfocus) and the ADHD criteria is definitely what I'm experiencing. There is a lot of overlap between the two conditions but the stuff that's specific to ADHD feels familiar, whereas the stuff specific to ASD does not.

 

To your point on ADHD meds—the idea that ADHDers feel calm on stimulants and non-ADHDers feel wired on meds—is a bit of a misconception. First of all, everyone's reactions to any kind of medication, regardless of what disorders they may have, are completely dependent on that person's biochemistry, and secondly, tied to the first point, a lot of that has to do with the dosages they are given.

 

Some ADHDers do not respond to stimulant medication. Something like 20-30 percent if I'm not mistaken. This has been noted in some studies. Those with ADHD-PI tend to have different reactions to stimulant medication. Usually, if they do respond to stimulant meds, they require a much smaller dose than what is typically prescribed.

 

It's very possible that the Ritalin I was given, 18mg, was too much for me. I'm a pretty small person, like 120-130 pounds. But regardless, my body adjusted to it quite quickly, and the therapeutic effect I noticed was definitely there. It's just that the side effects were too extreme and some of them were ingrained WITH the therapeutic effect, if that makes sense. What I mean is, it felt too much. I felt zombie-like and not myself. Also, this sort of stimulation gave me a lot of anxiety and I could not handle the crashes at all. These are not uncommon reactions for Ritalin.

 

I didn't try Adderall legally, but around this same time my ADHD friend suggested I give his Adderall a try just to see what would happen on a single dose. Unfortunately, that dose was designed for his body, and he'd been taking meds for a long time, so the dose was extremely high and it just gave me intense anxiety for a day. It was so extreme I couldn't notice any other effects. Had I tried Adderall at a dose that would have been appropriate for my PI, body weight, and novice status, it's entirely possible I would have had a therapeutic effect and no anxiety. Not sure! But based on everything I've read on nootropics forums I'm not entirely convinced Adderall is a good solution for the longer term.

 

And I DO feel therapeutic from the Atomoxetine. I feel calm. I feel focused. It works more in the background and it's not as in your face as Ritalin. I really appreciate that. I feel like myself. I still feel creative and capable of laughing at jokes and just being, I don't know, my usual self. It's definitely made an impact on the way I have been able to focus on things and switch my focus to other things. I can do tedious tasks like putting away laundry for like more than three minutes without feeling like I'm going to blow up. That in itself has been a life saver. See, for me, tasking switching has two almost contradictory components. Either I get lost in doing a task, which is hyperfocusing/perseverating, OR, I don't, and when I don't, I end up doing several things at once in a very inefficient manner and some of those things just end up not being completed. So say I'm doing laundry, but I also decide to sweep the floors, clean the kitchen, and clean the bathroom. On a whim. Because those things need to be done, and I just started doing laundry, so why not? I only have enough time to do maybe 2-3 out of those 4 tasks, but I decide I can do it all anyway. I don't think through just how much time it takes. And then, I attempt to do all these things at once. Because I hate the monotony of it so much the only way forward is to keep switching tasks. But I SUCK at switching tasks. I might end up on my phone for half an hour on my walk from the half-cleaned bathroom to the kitchen. Or I might decide that the broom sucks and then decide I absolutely need to visit the store to replace the broom brush. At some point, well before most of these chores are complete, I will get tired and just take a nap for like 2 hours, wake up, and decide I don't want to finish cleaning the bathroom or kitchen. The little dust heap I collected with the broom will stay in a corner until the next day when I have renewed energy to tackle something as simple as sweeping the floors again. Do you see what I'm saying? Meanwhile what I really should have done with all that wasted time was more important or urgent work. On Strattera, I can go actually think through how much time I need, what needs to be done first, and prioritize that way. Obviously it makes no sense to sweep if I desperately need a new broom. Going out and buying one takes too much time. I can write that down on a grocery list and deal with it later. The most urgent thing is to finish laundry, because I need clothes. Or maybe I have friends coming over tomorrow, so bathroom would be next on the list. Etcetera. The thing is, I feel like over the years I've discovered that I am a pretty practical and sensible person, it's just that my ADHD holds me back from executing on the things that make sense to me. 

 

I will say that my reaction to cocaine, which I've tried two times in my life, has been interesting w/r/t ADHD. I've done cocaine only in a strict, controlled, recreational capacity and don't ever plan on doing it again because, well, I'm not an idiot and I'm much more health conscious now than in my early twenties. Both instances were during a period of experimentation. Anyway. The first time, I did a line with several friends. I felt almost nothing. I say almost nothing  because it carried a tinge of the same "linear/logical thinking mindset" that I'd experienced on Ritalin. My other friends felt high though, like, the kind of high you get off cocaine. They did not believe me when I said I felt nothing. The second time I tried cocaine, I did much more than a single line. And it was only by the third or fourth that I finally felt the real high. My partner doing it with me got something off the first line. So there's that.

 

[z4l]

And no it was not me who tagged jack black's comment with that feedback.

[z4l]

Stinkorninjor, you said 70 mg is tolerable, but do you feel the therapeutic effect at that dosage?

 

I know the targeted clinical dose is supposed to be around 1.2mg/kg. It's strange because some of the prescription information I see mentions that being relevant for dosing for children/adolescents, and then says the therapeutic dose for adults is 80mg, but why would body weight no longer be relevant as soon as a person reaches adulthood? Given the wide spectrum of body weights for adults I can see right dosage playing a hugely important role. Maybe that's why so many people have a bad reaction. Maybe 80mg is too much for them and 60 or 70 or 75mg is the right amount. Or 80mg is not enough, but 100mg is too much, and what they really needed was 90mg.

 

If the dosing is that specific even for adults, then I would require just under 70mg. But I don't think I or my doctor can request the pharmacist to give a unique dose, even with the generic, correct? Or maybe I could take take the 60mg plus a 10mg pill. I'll have to inquire and see about my options.

[Duchykins]

Hmm I'm not so sure. I know that autism is different in women, but I've looked at the diagnosis criteria for ASD in the past and it's never quite clicked. I've been very concerned and am quite sensitive on this subject since ADHD also tends to present itself differently in women and I know fully well just how well I've been able to mask my symptoms for so many years and how a big part of that has to do with gender conditioning, as well as having PI.

 

Self-diagnosing is not the same as a full medical assessment, which would be great, but FWIW, I've worked with a psychiatrist+psychologist for four years and he firmly believes I have ADHD. I don't think his experience lies in diagnosing ASD, so sure to your point, it's definitely difficult to find someone who can work past the gender bias. But I tend to be a bit of a hypochondriac w/r/t my mental health and I have researched both of these conditions on my own (yay hyperfocus) and the ADHD criteria is definitely what I'm experiencing. There is a lot of overlap between the two conditions but the stuff that's specific to ADHD feels familiar, whereas the stuff specific to ASD does not.

 

To your point on ADHD meds—the idea that ADHDers feel calm on stimulants and non-ADHDers feel wired on meds—is a bit of a misconception. First of all, everyone's reactions to any kind of medication, regardless of what disorders they may have, are completely dependent on that person's biochemistry, and secondly, tied to the first point, a lot of that has to do with the dosages they are given.

 

Some ADHDers do not respond to stimulant medication. Something like 20-30 percent if I'm not mistaken. This has been noted in some studies. Those with ADHD-PI tend to have different reactions to stimulant medication. Usually, if they do respond to stimulant meds, they require a much smaller dose than what is typically prescribed.

 

It's very possible that the Ritalin I was given, 18mg, was too much for me. I'm a pretty small person, like 120-130 pounds. But regardless, my body adjusted to it quite quickly, and the therapeutic effect I noticed was definitely there. It's just that the side effects were too extreme and some of them were ingrained WITH the therapeutic effect, if that makes sense. What I mean is, it felt too much. I felt zombie-like and not myself. Also, this sort of stimulation gave me a lot of anxiety and I could not handle the crashes at all. These are not uncommon reactions for Ritalin.

 

I didn't try Adderall legally, but around this same time my ADHD friend suggested I give his Adderall a try just to see what would happen on a single dose. Unfortunately, that dose was designed for his body, and he'd been taking meds for a long time, so the dose was extremely high and it just gave me intense anxiety for a day. It was so extreme I couldn't notice any other effects. Had I tried Adderall at a dose that would have been appropriate for my PI, body weight, and novice status, it's entirely possible I would have had a therapeutic effect and no anxiety. Not sure! But based on everything I've read on nootropics forums I'm not entirely convinced Adderall is a good solution for the longer term.

 

And I DO feel therapeutic from the Atomoxetine. I feel calm. I feel focused. It works more in the background and it's not as in your face as Ritalin. I really appreciate that. I feel like myself. I still feel creative and capable of laughing at jokes and just being, I don't know, my usual self. It's definitely made an impact on the way I have been able to focus on things and switch my focus to other things. I can do tedious tasks like putting away laundry for like more than three minutes without feeling like I'm going to blow up. That in itself has been a life saver. See, for me, tasking switching has two almost contradictory components. Either I get lost in doing a task, which is hyperfocusing/perseverating, OR, I don't, and when I don't, I end up doing several things at once in a very inefficient manner and some of those things just end up not being completed. So say I'm doing laundry, but I also decide to sweep the floors, clean the kitchen, and clean the bathroom. On a whim. Because those things need to be done, and I just started doing laundry, so why not? I only have enough time to do maybe 2-3 out of those 4 tasks, but I decide I can do it all anyway. I don't think through just how much time it takes. And then, I attempt to do all these things at once. Because I hate the monotony of it so much the only way forward is to keep switching tasks. But I SUCK at switching tasks. I might end up on my phone for half an hour on my walk from the half-cleaned bathroom to the kitchen. Or I might decide that the broom sucks and then decide I absolutely need to visit the store to replace the broom brush. At some point, well before most of these chores are complete, I will get tired and just take a nap for like 2 hours, wake up, and decide I don't want to finish cleaning the bathroom or kitchen. The little dust heap I collected with the broom will stay in a corner until the next day when I have renewed energy to tackle something as simple as sweeping the floors again. Do you see what I'm saying? Meanwhile what I really should have done with all that wasted time was more important or urgent work. On Strattera, I can go actually think through how much time I need, what needs to be done first, and prioritize that way. Obviously it makes no sense to sweep if I desperately need a new broom. Going out and buying one takes too much time. I can write that down on a grocery list and deal with it later. The most urgent thing is to finish laundry, because I need clothes. Or maybe I have friends coming over tomorrow, so bathroom would be next on the list. Etcetera. The thing is, I feel like over the years I've discovered that I am a pretty practical and sensible person, it's just that my ADHD holds me back from executing on the things that make sense to me. 

 

I will say that my reaction to cocaine, which I've tried two times in my life, has been interesting w/r/t ADHD. I've done cocaine only in a strict, controlled, recreational capacity and don't ever plan on doing it again because, well, I'm not an idiot and I'm much more health conscious now than in my early twenties. Both instances were during a period of experimentation. Anyway. The first time, I did a line with several friends. I felt almost nothing. I say almost nothing  because it carried a tinge of the same "linear/logical thinking mindset" that I'd experienced on Ritalin. My other friends felt high though, like, the kind of high you get off cocaine. They did not believe me when I said I felt nothing. The second time I tried cocaine, I did much more than a single line. And it was only by the third or fourth that I finally felt the real high. My partner doing it with me got something off the first line. So there's that.

 

Fair enough.  You raise several good points.

 

But there's not much contradictory about task-switching/set-shifting.  Both needing a lot of time to shift into a new task and having difficulty phasing out of another task are two sides of the same coin.  It's why I have to have several hours between my classes and several hours between studying one thing and then studying another. 

 

The Strattera helps you.  That might be all that matters, in the end. 

 

Have you ever tried 200 mg theanine doses with it?

[Mind_Paralysis]

 

Hmm I'm not so sure. I know that autism is different in women, but I've looked at the diagnosis criteria for ASD in the past and it's never quite clicked. I've been very concerned and am quite sensitive on this subject since ADHD also tends to present itself differently in women and I know fully well just how well I've been able to mask my symptoms for so many years and how a big part of that has to do with gender conditioning, as well as having PI.

 

Self-diagnosing is not the same as a full medical assessment, which would be great, but FWIW, I've worked with a psychiatrist+psychologist for four years and he firmly believes I have ADHD. I don't think his experience lies in diagnosing ASD, so sure to your point, it's definitely difficult to find someone who can work past the gender bias. But I tend to be a bit of a hypochondriac w/r/t my mental health and I have researched both of these conditions on my own (yay hyperfocus) and the ADHD criteria is definitely what I'm experiencing. There is a lot of overlap between the two conditions but the stuff that's specific to ADHD feels familiar, whereas the stuff specific to ASD does not.

 

To your point on ADHD meds—the idea that ADHDers feel calm on stimulants and non-ADHDers feel wired on meds—is a bit of a misconception. First of all, everyone's reactions to any kind of medication, regardless of what disorders they may have, are completely dependent on that person's biochemistry, and secondly, tied to the first point, a lot of that has to do with the dosages they are given.

 

Some ADHDers do not respond to stimulant medication. Something like 20-30 percent if I'm not mistaken. This has been noted in some studies. Those with ADHD-PI tend to have different reactions to stimulant medication. Usually, if they do respond to stimulant meds, they require a much smaller dose than what is typically prescribed.

 

It's very possible that the Ritalin I was given, 18mg, was too much for me. I'm a pretty small person, like 120-130 pounds. But regardless, my body adjusted to it quite quickly, and the therapeutic effect I noticed was definitely there. It's just that the side effects were too extreme and some of them were ingrained WITH the therapeutic effect, if that makes sense. What I mean is, it felt too much. I felt zombie-like and not myself. Also, this sort of stimulation gave me a lot of anxiety and I could not handle the crashes at all. These are not uncommon reactions for Ritalin.

 

I didn't try Adderall legally, but around this same time my ADHD friend suggested I give his Adderall a try just to see what would happen on a single dose. Unfortunately, that dose was designed for his body, and he'd been taking meds for a long time, so the dose was extremely high and it just gave me intense anxiety for a day. It was so extreme I couldn't notice any other effects. Had I tried Adderall at a dose that would have been appropriate for my PI, body weight, and novice status, it's entirely possible I would have had a therapeutic effect and no anxiety. Not sure! But based on everything I've read on nootropics forums I'm not entirely convinced Adderall is a good solution for the longer term.

 

And I DO feel therapeutic from the Atomoxetine. I feel calm. I feel focused. It works more in the background and it's not as in your face as Ritalin. I really appreciate that. I feel like myself. I still feel creative and capable of laughing at jokes and just being, I don't know, my usual self. It's definitely made an impact on the way I have been able to focus on things and switch my focus to other things. I can do tedious tasks like putting away laundry for like more than three minutes without feeling like I'm going to blow up. That in itself has been a life saver. See, for me, tasking switching has two almost contradictory components. Either I get lost in doing a task, which is hyperfocusing/perseverating, OR, I don't, and when I don't, I end up doing several things at once in a very inefficient manner and some of those things just end up not being completed. So say I'm doing laundry, but I also decide to sweep the floors, clean the kitchen, and clean the bathroom. On a whim. Because those things need to be done, and I just started doing laundry, so why not? I only have enough time to do maybe 2-3 out of those 4 tasks, but I decide I can do it all anyway. I don't think through just how much time it takes. And then, I attempt to do all these things at once. Because I hate the monotony of it so much the only way forward is to keep switching tasks. But I SUCK at switching tasks. I might end up on my phone for half an hour on my walk from the half-cleaned bathroom to the kitchen. Or I might decide that the broom sucks and then decide I absolutely need to visit the store to replace the broom brush. At some point, well before most of these chores are complete, I will get tired and just take a nap for like 2 hours, wake up, and decide I don't want to finish cleaning the bathroom or kitchen. The little dust heap I collected with the broom will stay in a corner until the next day when I have renewed energy to tackle something as simple as sweeping the floors again. Do you see what I'm saying? Meanwhile what I really should have done with all that wasted time was more important or urgent work. On Strattera, I can go actually think through how much time I need, what needs to be done first, and prioritize that way. Obviously it makes no sense to sweep if I desperately need a new broom. Going out and buying one takes too much time. I can write that down on a grocery list and deal with it later. The most urgent thing is to finish laundry, because I need clothes. Or maybe I have friends coming over tomorrow, so bathroom would be next on the list. Etcetera. The thing is, I feel like over the years I've discovered that I am a pretty practical and sensible person, it's just that my ADHD holds me back from executing on the things that make sense to me. 

 

I will say that my reaction to cocaine, which I've tried two times in my life, has been interesting w/r/t ADHD. I've done cocaine only in a strict, controlled, recreational capacity and don't ever plan on doing it again because, well, I'm not an idiot and I'm much more health conscious now than in my early twenties. Both instances were during a period of experimentation. Anyway. The first time, I did a line with several friends. I felt almost nothing. I say almost nothing  because it carried a tinge of the same "linear/logical thinking mindset" that I'd experienced on Ritalin. My other friends felt high though, like, the kind of high you get off cocaine. They did not believe me when I said I felt nothing. The second time I tried cocaine, I did much more than a single line. And it was only by the third or fourth that I finally felt the real high. My partner doing it with me got something off the first line. So there's that.

 

Fair enough.  You raise several good points.

 

But there's not much contradictory about task-switching/set-shifting.  Both needing a lot of time to shift into a new task and having difficulty phasing out of another task are two sides of the same coin.  It's why I have to have several hours between my classes and several hours between studying one thing and then studying another. 

 

The Strattera helps you.  That might be all that matters, in the end. 

 

Have you ever tried 200 mg theanine doses with it?

 

 

All though you brought up many good points about the similarities to Autism, I'm not sure if you're aware of a disease called SCT - Sluggish Cognitive Tempo?

I myself identify with that disorder, and have been diagnosed with ADHD-PI (a derelict term now, but it captures the difference) - much like z4l.

 

I was also able to mask my symptoms to an extent while growing up - I had some talents which made it so I didn't fail in school, for instance. (less problems with school-tuition than ADHD seems to be a pattern btw, reiterated by both Dr. Barkley and various SCT-identifiers online) The problems came when trying to pursue a career and live a stable life as an adult - not possible.

 

SCT shares similarities with both ADHD and Autism, as well as NARCOLEPSY - but it is none of them, it's something else.
 

 

The fact that z4l has ANY benefit from Atomoxetine is actually a sign towards SCT - because the disease is hypothesized to be connected to Norepinephrinergic networks in the brain, and the subjects scanned have fewer neural abnormalities than Autists - one of the reasons why they've been able to pin it down to NE-related networks at all - Autism isn't as easily pinned down, and the abnormalities are less consistent.

The Superior Parietal Lobe seems to be where most of the problem lies - a section in the BACK of the head, which handles both sensory integration and certain aspects of attention. It's also a region which neural mapping has shown to be not just greatly influenced by Norepinephrinergic activity (brain-damage to this part of the head is actually treated with NE-agents, hence how Dr. Barkley came up with the idea that it might be an NE-disease), but also a region structurally dominated mostly by norepinephrinergic Alpha-2-receptors.

 

 

I myself correspond somewhat to Autistic features (my sister for instance, long thought I had autism), but I have been thoroughly tested, TWICE, and twice the results came up empty - I score higher than the neurotypical majority, about 20% higher, if I recall correctly - however, even with the updated autism-scales, which incorporates "Atypical Autism" - a form of Autism even MILDER than classical Aspergers (precisely because there have long been patients which after many evaluations and a long time in the healthcare-systems have been found to be "threshold cases", which could not previously get the help they needed), I still fall short of the diagnosis, with at least 30 points! : O

 

Other research also shows that a subset of ADHD-ers seems to, for some reason, even though they DON'T have it, score higher on Autism-testing than neurotypicals. (gee... wonder which subgroup it could be...?)

 

 

The data I've seen on favourable response from autistic patients treated with Atomoxetine only mentioned the same old, same old when it comes to Autistic drug-response: a decrease in anxiety and/or aggression.

 

Last time I checked, what Z4L describes isn't that - what she describes sound more like cognitive enhancement, akin to executive functions.

 

 

I recognize the experience she's describing, I have experienced similar things on Atomoxetine - I still stand by that it has helped MORE than both Dexamphetamine or Methylphenidate.

 

A small note, is that I have not, unlike the majority of ADHD-ers taking the drug, experienced the same amount of anxiogenic, peripheral, or depressive side-effects - except for the upper ends of the dosing-spectrum, it's actually been somewhat anxiolytic! = )

 

I also, similar to z4l, find stimulants to be, well, STIMULATING! They're note only stimulating though, they've also improved some of the symptoms - less distractability, less sluggishness - however, even though I've tried multiple formulations and dosages, it's never helped as much as what the ADHD-ers describe...

However, unlike the neurotypicals I know, I don't find the substances either addicting or "euphoriating" - quite the opposite!

Most dopaminergics actually make me feel like SH*T emotionally...! That, is as far as I can tell, a MOST atypical response to dopaminergics...! It doesn't fit either ADHD, Neurotypicality, Autism or even Schizoform disorders.

 

 

It does, however, fit with a disease (SCT) which is linked to PUNISHMENT SENSITIVITY - the sense that there's no point in trying, or doing, ANYthing, because nothing will succeed, hence you will never feel a reward, hence there's no point in doing risky things.

 

 

Now, I could be wrong - there is such a thing such as projecting, putting my own experiences in place of actually analyzing Z4L's experiences, but I do feel there are similarities here... things which just doesn't add up with Autism or classical ADHD.

 

 

Z4L, wadda'ya' think? Does this ring any bells, or am I just pulling stuff outta' my @$$?

[z4l]

I agree with Dutchykins, the whole story remind​s me a family member who was officially diagnosed with dyslexia, ADHD, and depression (by different docs), but I suspect she has mild autism/Asperger's combined with social anxiety. She also suffered from low self esteem her entire life. She also poorly responds to ADHD treatments. She got better when I put her on my stack, but sadly she is too disorganized and stubborn to take that huge pile of pills and powders by herself.

 

Okay so based on Dutchykins and jack black's posts I did some more searching on Autism last night. I found this checklist of Asperger's symptoms specific to women, and some, maybe even a fair bit (like 60-75%?) definitely applies to me. But I just see a lot of unproblematic traits that I and many people I know happen to have (apparently neurodivergents tend to find other neurodivergent friends, but I also happen to have NT friends and there are distinct differences). As in, these traits seem to be more personality quirks than problematic symptoms in a clinical sense. To use an ADHD example, I can see how a trait like being late or forgetting appointments (exec functioning problems) can be problematic and dysfunctional in a person's life (that is my life). But other symptoms like fidgeting or "out of the box thinking" stuff that is also common to high-functioning ADHDers is more a personality trait than clinically problematic in my opinion, or at least that's been my experience. I can see hypothetical examples where those traits could be abnormal to the point of social exclusion, but I think high-functioning people with these disorders have a tendency to "normalize" themselves to fit in. I've done that for sure.

 

I'm not trying to trivialize Asperger's because I think if you take a holistic look at these symptoms, they can definitely wreak havoc in a person's life on multiple dimensions, and that's actually where I identify with this checklist the most. I am, no matter where I fall on the ADHD or ASD or any other scale, not a normal person. I have tried to be. I'm Iranian by birth and grew up in Canada, so the immigrant mentality established by my parents was to keep your nose down and to fit in as best as possible. And that's what I've tried to do, to varying degrees of success, for years. I've always been a social outcast. And it's hurt me, and I have social anxiety, generalized anxiety, and depression, much of it likely to do with the general neurodivergent-ness of my self. I've never liked group interactions. I've tried office jobs. School sucked but I have a high IQ and I've successfully got myself some great, high-paying gigs. But I could never lead a normie life. I can't handle the deeper existential aspect of doing meaningless work. I found a passion and worked my ass off to make it my full-time job (and now I'm trying to grow that into something that actually pays more than living hand to mouth). There's a lot of stuff in this checklist and ADHD personality checklists that can be tied to my neuroatypical personality, and it's who I identify as. I guess what I'm trying to say is, I'm pretty okay with who I am, quirks and all. I've adapted to many social problems in my life. I've surrounded myself with friends who are accommodating to my needs, who are supportive, who get me. The place where I've had problems in a CLINICAL sense, which is to say, the areas where my life is still dysfunctional, involves a lot of the executive functioning areas that I and Stinorninjor have described. So at the end of the day, I am trying to resolve that through Strattera and other nootropics.

 

Jack Black, I'm curious to know, what is your stack?

Edited by z4l, 17 March 2017 - 02:36 PM.

[z4l]

Fair enough.  You raise several good points.

 

But there's not much contradictory about task-switching/set-shifting.  Both needing a lot of time to shift into a new task and having difficulty phasing out of another task are two sides of the same coin.  It's why I have to have several hours between my classes and several hours between studying one thing and then studying another. 

 

The Strattera helps you.  That might be all that matters, in the end. 

 

Have you ever tried 200 mg theanine doses with it?

 

 

I haven't tried it no, and I should. I've been meaning to replace my two daily cups of chai tea with some high-quality green tea, and if anyone has any recommendations that I can buy online, please let me know. Otherwise I might try dosing l-theanine.

 

And yes I agree they are the same coin. That's a good strategy. Sometimes I think we need to blow off steam between activities and do something radically different in order to switch successfully.

[z4l]

All though you brought up many good points about the similarities to Autism, I'm not sure if you're aware of a disease called SCT - Sluggish Cognitive Tempo?

I myself identify with that disorder, and have been diagnosed with ADHD-PI (a derelict term now, but it captures the difference) - much like z4l.

 

I was also able to mask my symptoms to an extent while growing up - I had some talents which made it so I didn't fail in school, for instance. (less problems with school-tuition than ADHD seems to be a pattern btw, reiterated by both Dr. Barkley and various SCT-identifiers online) The problems came when trying to pursue a career and live a stable life as an adult - not possible.

 

SCT shares similarities with both ADHD and Autism, as well as NARCOLEPSY - but it is none of them, it's something else.
 

 

The fact that z4l has ANY benefit from Atomoxetine is actually a sign towards SCT - because the disease is hypothesized to be connected to Norepinephrinergic networks in the brain, and the subjects scanned have fewer neural abnormalities than Autists - one of the reasons why they've been able to pin it down to NE-related networks at all - Autism isn't as easily pinned down, and the abnormalities are less consistent.

The Superior Parietal Lobe seems to be where most of the problem lies - a section in the BACK of the head, which handles both sensory integration and certain aspects of attention. It's also a region which neural mapping has shown to be not just greatly influenced by Norepinephrinergic activity (brain-damage to this part of the head is actually treated with NE-agents, hence how Dr. Barkley came up with the idea that it might be an NE-disease), but also a region structurally dominated mostly by norepinephrinergic Alpha-2-receptors.

 

 

I myself correspond somewhat to Autistic features (my sister for instance, long thought I had autism), but I have been thoroughly tested, TWICE, and twice the results came up empty - I score higher than the neurotypical majority, about 20% higher, if I recall correctly - however, even with the updated autism-scales, which incorporates "Atypical Autism" - a form of Autism even MILDER than classical Aspergers (precisely because there have long been patients which after many evaluations and a long time in the healthcare-systems have been found to be "threshold cases", which could not previously get the help they needed), I still fall short of the diagnosis, with at least 30 points! : O

 

Other research also shows that a subset of ADHD-ers seems to, for some reason, even though they DON'T have it, score higher on Autism-testing than neurotypicals. (gee... wonder which subgroup it could be...?)

 

 

The data I've seen on favourable response from autistic patients treated with Atomoxetine only mentioned the same old, same old when it comes to Autistic drug-response: a decrease in anxiety and/or aggression.

 

Last time I checked, what Z4L describes isn't that - what she describes sound more like cognitive enhancement, akin to executive functions.

 

 

I recognize the experience she's describing, I have experienced similar things on Atomoxetine - I still stand by that it has helped MORE than both Dexamphetamine or Methylphenidate.

 

A small note, is that I have not, unlike the majority of ADHD-ers taking the drug, experienced the same amount of anxiogenic, peripheral, or depressive side-effects - except for the upper ends of the dosing-spectrum, it's actually been somewhat anxiolytic! = )

 

I also, similar to z4l, find stimulants to be, well, STIMULATING! They're note only stimulating though, they've also improved some of the symptoms - less distractability, less sluggishness - however, even though I've tried multiple formulations and dosages, it's never helped as much as what the ADHD-ers describe...

However, unlike the neurotypicals I know, I don't find the substances either addicting or "euphoriating" - quite the opposite!

Most dopaminergics actually make me feel like SH*T emotionally...! That, is as far as I can tell, a MOST atypical response to dopaminergics...! It doesn't fit either ADHD, Neurotypicality, Autism or even Schizoform disorders.

 

 

It does, however, fit with a disease (SCT) which is linked to PUNISHMENT SENSITIVITY - the sense that there's no point in trying, or doing, ANYthing, because nothing will succeed, hence you will never feel a reward, hence there's no point in doing risky things.

 

 

Now, I could be wrong - there is such a thing such as projecting, putting my own experiences in place of actually analyzing Z4L's experiences, but I do feel there are similarities here... things which just doesn't add up with Autism or classical ADHD.

 

 

Z4L, wadda'ya' think? Does this ring any bells, or am I just pulling stuff outta' my @$$?

 

 

This rings so many bells! What you're describing is eerily similar to my own experiences.

 

And I'm willing to bet if I went through formal ASD testing—again, assuming the people testing me were familiar with the gendered differences—I'd have some similar results to you...!

 

I have some questions about SCT compared to ADHD-PI. There are some symptoms specific to ADHD that seem to match me more, actually, maybe it's just the impulsivity. Which from what I understand is not an SCT trait? I am not a thrill seeker, but I will, for example, go shopping on a whim. So I act out my impulsivity through purchases and things like that. I've watched some of Berkley's videos on SCT but I'm wondering if there's like a more generalized summary of how SCT differs from ADHD that I can take a look at? I'd like to learn more but so far the research I've done finds partial descriptions and no real analysis comparing ADHD-PI to SCT. 

 

Stinkorninjor and anyone else who reading this identifies with these traits: What nootropics and supplements have you taken that you've found to be helpful? 

 

I may try Tianeptine. I'm going to see if I can find a way to ship it to Canada.

 

BTW! Last couple of days have been a lot smoother for me, depression/anger is mostly gone, but my sleeping is still not as smooth and who knows how much that and my monthly cycle are playing a role in all of this... So, I'm going to ask my doc to titrate down. 

[Mind_Paralysis]

 

 

This rings so many bells! What you're describing is eerily similar to my own experiences.

 

And I'm willing to bet if I went through formal ASD testing—again, assuming the people testing me were familiar with the gendered differences—I'd have some similar results to you...!

 

I have some questions about SCT compared to ADHD-PI. There are some symptoms specific to ADHD that seem to match me more, actually, maybe it's just the impulsivity. Which from what I understand is not an SCT trait? I am not a thrill seeker, but I will, for example, go shopping on a whim. So I act out my impulsivity through purchases and things like that. I've watched some of Berkley's videos on SCT but I'm wondering if there's like a more generalized summary of how SCT differs from ADHD that I can take a look at? I'd like to learn more but so far the research I've done finds partial descriptions and no real analysis comparing ADHD-PI to SCT. 

 

Stinkorninjor and anyone else who reading this identifies with these traits: What nootropics and supplements have you taken that you've found to be helpful? 

 

I may try Tianeptine. I'm going to see if I can find a way to ship it to Canada.

 

BTW! Last couple of days have been a lot smoother for me, depression/anger is mostly gone, but my sleeping is still not as smooth and who knows how much that and my monthly cycle are playing a role in all of this... So, I'm going to ask my doc to titrate down. 

 

 

Impulsivity is not an SCT-trait, no - it's an ADHD-trait, believed to be rooted in the same abnormalities which cause the hyperactivity.
 

I've found Fasoracetam to be somewhat helpful for the problems with motivation, while Magnesium and Omega-3 is good for overall mental health.

 

 

I found a rather good run-down on what Barkley at least, considers the differences between SCT and ADHD, on Reddit:
 

https://www.reddit.c...adhdpi_and_sct/

 

 

The easiest, SIMPLEST, noticeable difference between the two is the daydreaming: SCT-ers can often become completely blank in expression, as if they are suddenly struck with involuntary meditation - they will then sit quietly and stare into the far distance, even in a crowded classroom - ADHD-ers will respond the opposite way, becoming instead more agitated, and frustrated.

 

 

 

Side-note: the emotional instability which is prevalent in some ADHD-ers (which has an eerie similarity to Borderline disorder) is believed to be a third dimension of the disease, and is thought to be connected to abnormalities in the PFC - do you have any problems with controlling emotion as well? Do you show more emotions than others, at times?

 

I've displayed some ADHD-traits throughout life as well, but instead of hyperactivity or impulsivity, I've shown some traits which seem similar to the emotional aspect - a bit like oppositional defiance disorder almost! Banging doors and the floor, while having intense anxiety or just exploding into rage when in an emotionally charged discussion.

 

 

It's curious though, because I dated a lady which corresponds to both Borderline and ADHD (she is being evaluated for both, and the ADHD-diagnosis is pretty much set at the moment, it only needs to be finalized, as I understand it), and compared to her, I'm an extremely well-adapted and emotion-regulating individual - she often looked to me for stabilizing during her emotional swings - I'm also a LOT more mediating than her, often trying to resolve arguments by trying to negotiate and understand how she thinks. (often, I was rather dumb-struck by why she was so upset - which is in line either with her displaying emotional instability, or with me displaying autistic traits)

 

The fact that I don't have a criminal record and more friends than her, might imply that my previous difficulties with behaviour might have been from intense environmental pressures during the times in the past when I had such difficulties (some instances of such may actually have been medication-induced), and less to do with an inherent deficit in behavioural control.

 

 

Anyways, many patients seem to correspond to some traits from both, in fact, Dr. Barkley himself believes that up to 33% of all ADHD-PI patients may have both diseases, (SCT + ADHD) so even though you may identify more with SCT-symptoms than ADHD-symptoms, you could still have both diseases, and your medications could then need adjusting to reflect that.

 

 

Another side-note: impulsivity is, as far as I can tell*, not an inherent Autistic trait - autism doesn't make you inherently less able to resist sweets or not follow traffic-regulations - the only times an Autistic person may seem impulsive is within a social context, where they may speak out of mind in certain situations.

 

*(I actually went through the litterature on this, and although there are mentions of impulsivity, the researchers do not appear to be clear on whether this is an inherent trait of autism, or whether the kids with autism and impulsivity don't just also have ADHD - because they all seem to display OTHER ADHD-traits as well, the impulsive ones)

[metabrain]

Do you suffer from excessive tiredness? Yawning?

[z4l]

Do you suffer from excessive tiredness? Yawning?

 

I don't yawn a lot but I do tend to get tired pretty easily. Strenuous exercise has made the biggest difference in this regard. My life before and after I started working out is remarkably different. I've been a lot happier and more energetic since I joined a gym and learned how to do weight training. However, because I injured my back, I am limited to doing a very gentle walk right now until it gets better (also doing heat pad and massage treatment). It's been over a month now and I haven't made much progress. I miss the bootcamp :(

 

I think right now I'm a lot more tired than I usually am because of this lack of exercise. It sucks. 

[z4l]

The easiest, SIMPLEST, noticeable difference between the two is the daydreaming: SCT-ers can often become completely blank in expression, as if they are suddenly struck with involuntary meditation - they will then sit quietly and stare into the far distance, even in a crowded classroom - ADHD-ers will respond the opposite way, becoming instead more agitated, and frustrated.

 

Side-note: the emotional instability which is prevalent in some ADHD-ers (which has an eerie similarity to Borderline disorder) is believed to be a third dimension of the disease, and is thought to be connected to abnormalities in the PFC - do you have any problems with controlling emotion as well? Do you show more emotions than others, at times?

 

I've displayed some ADHD-traits throughout life as well, but instead of hyperactivity or impulsivity, I've shown some traits which seem similar to the emotional aspect - a bit like oppositional defiance disorder almost! Banging doors and the floor, while having intense anxiety or just exploding into rage when in an emotionally charged discussion.

 

 

I am very easily affected by emotion. It can shut me down for days. CBT has proven only mildly helpful in this regard. My therapist's practice is a mix of a few talk therapies and CBT is only one of them and it's pretty minor. It's not as easy to work with him on emotional stuff, but I have in the past and now I'm trying to divert all my attention on solving my EF problems since my career is at stake here. Also, I find myself avoiding dealing with internal emotional conflicts a lot, too. Like something will bug me and I won't quite be able to put my finger on it, or I'll go, oh it's just me being like this again, just move on, and then I won't be able to and become confused why that is. Then a few days later I'll think it through and realize it was because of some new detail that complicated the situation and all I had to do was work through everything in my head. And take action, or not take action. All of that stuff takes a lot of time. I also get some support from my sister—she's a born natural at CBT without even knowing what that is. Talking to her and some of my friends helps me a lot to process emotional stuff.

 

Thx for the link, btw. So based on that and some research I've done for ADHD-PI and SCT, it looks like I am a mix of both. The spaciness is definitely me. I also never really identified with the ADHD symptom of racing thoughts or having too many thoughts. Occasionally that might be true for me, but most of the time I'm really just out to lunch. When I started reading some of the really specific, smaller symptoms people describe on the SCT subreddit the one I really identified with was asking people to repeat themselves, because their words register a second after I hear it. But I still can't stop myself from saying "what?" I do this all the time. Drives my husband crazy.

 

Would NSI-189 be a good idea to try? Or Tianeptine? Would NSI-189 be okay to take with Atomoxetine?

[z4l]

I'm curious in trying NSI-189 not only because of the anti-depressant qualities, which I'm not sure might help me specifically, but because I have a really terrible memory—of all kinds, short, long, working, procedural, declarative. The worst offenders are actually my short-term and long-term memory. With working memory I've found some coping mechanisms around it, and I think it's actually better than most people, but definitely subpar for my intelligence levels. Makes things very frustrating. I've had trouble following films and tv shows in the past based on working and short-term memory recall and since my job mostly consists of reviewing and writing on movies and films, it's a pretty terrible handicap. My strategy so far has been to take notes as often as possible and reviewing a film/episode mentally after it's over, and to make additional notes, as this helps, but I'm inconsistent at maintaining this practice. 

 

 

[metabrain]

 

Do you suffer from excessive tiredness? Yawning?

 

I don't yawn a lot but I do tend to get tired pretty easily. Strenuous exercise has made the biggest difference in this regard. My life before and after I started working out is remarkably different. I've been a lot happier and more energetic since I joined a gym and learned how to do weight training. However, because I injured my back, I am limited to doing a very gentle walk right now until it gets better (also doing heat pad and massage treatment). It's been over a month now and I haven't made much progress. I miss the bootcamp :(

 

I think right now I'm a lot more tired than I usually am because of this lack of exercise. It sucks. 

 

How tired? Would you sleep all the time during the day?

[z4l]

 

How tired? Would you sleep all the time during the day?

 

 

 

No I wouldn't sleep all day, though if I have nothing to do or am procrastinating from doing something I generally just lounge around and surf the internet or watch tv shows, something super low key. I've always been very low-energy and lethargic. Trouble waking up in the morning, I'm slow to start the day, more of a night owl, have trouble falling asleep, etc. This has been true since puberty. Exercise, sleep hygiene, and a healthy diet helps these things but I've never been super consistent enough to see any kind of long-term effect this might have on my productivity.

 

But it's different now that I'm on Atomoxetine (and possibly at too high a dose, though I'll be changing that in a few days) and unable to do the strenuous exercise that helps me so much. Since I had my anger freak-out I've been more lethargic and kinda out of it than usual. I can usually get started on a task if I try, and I can switch tasks, but I'm still not sure what the hell is going on with me and this drug. I've now completed seven weeks, three of them at 80mg. I know they say it takes a month to kick in and I've been on a longer titration process than what is recommended, so I'm trying to be very patient and see what 70-80mg does for me. Things definitely feel different no matter what, and I like that, I like the logic ordering that's going on up in my noggin, but the effects of this drug are far too inconsistent right now for me to really get a sense of how I'm doing. 

[z4l]

 

I started the most recent cycle on the 27th of February, and have been using it ever since - that makes for a total of 16 days of treatment. Hmm... I can see how this might be a bit too aggressive of a dosing-schedule - I was able to be aggressive with the dosing thanks to Armodafinil! About 37,5 mg's takes away many of the worst side-effects for me, and becomes synergistic.

 

Currently on 70 mg, at day 16.

 

So far, 70 mg seems more tolerable than 80 mg - however, yesterday I did NOT use Armodafinil, since I felt the need to get in bed early, and that may have to do with my feelings of aggression and anxiety yesterday - I was quite fatigued, most likely from ATX side-effects yesterday, so that may have affected mood.

 

Can you describe in more detail the acute effects you get from combining Atomoxetine with Armodafinil? I'm interested in trying a few different combos with Atomoxetine once I figure out my dosing situation and stabilize the right dose (probably 70mg) for at least 2-3 weeks. Hopefully by then I have my sleep hygiene in better control. I'm still not sure I'm getting enough REM and/or deep sleep on Atomoxetine—at least not on 80mg.

 

Moda/Armodafinil is one of those combos. It sounds extremely powerful. Maybe even... too powerful?