Hi there:

Great question! I haven't read anything about ADHD drugs causing adverse reactions with PMS, but it's definitely possible given that ADHD meds are designed to regulate your dopamine levels, which are also impacted by estrogen levels (which rise or drop with pregnancy, menopause, PMS, etc.)

It could be the drug. Or it could be ADD itself that's causing your symptoms.

Either way, I would recommend reading Women with Attention Deficit by Sari Solden. It delves into all of these issues and may give you some more concrete ideas re: next steps.

Best of luck!

Quote

I noticed that book in my research and was actually planning on picking it up today - thanks!

I've been thinking it could also be an interaction with my birth control. Or maybe even a "perfect storm" of all these elements. If I find out anything interesting, I'll be sure to post the results.

Quote

I believe based on the description given in "Understanding Women with AD/HD" that I have issues with PMDD - think of PMS without the cramping, bloating etc - just the emotional effects and AD/HD is made worse/more noticeable by dropping hormone levels. I went through horrible times as a teen, and again now during peri-menopause.

The book I've mentioned above, really helped me understand what I'd been going through as a woman with ADHD, and was solely responsible for actually sending me for assessment at age 50. It is written by Kathleen G. Nadeau, Ph.D. and Patricia O. Quinn, M.D. It might also be a good addition to your library. I have both Sari Solden's book and this one, in addition to a book on ADD Friendly ways to organize by Nadeau and Quinn. All three are well worth the price paid.

Quote

This is my first time to go on a forum about my daughter. She is 12 and has dyslexia and ADHD. She has been on Concerta for about 18 months. It does seem to help, we call it smoothing her out. However, we have seen a definite sadness in her the last few weeks. She just wanders around aimlessly and can't name what is bothering her. Then last night she just burst out crying at the dinner table and has been crying ever since. She still can't name what is bothering her, she doesn't want to eat anything and couldn't go to school today because she couldn't stop crying. She is also having her period this week. (She has had her period for almost a year.) We do have depression/bi-polar people in our family tree (diagnosed and un-diagnosed). I will call her doctor, but we currently just see the pediatrician for her meds. I am wondering what anyone else could recommend for us. I will not give her anymore Concerta until I understand what is going on. Thanks for anyone's thoughts or suggestions.

Quote

Hi, I'm sorry to hear your daughter is having such a hard time. I also noticed a general, pervasive sadness when I started on the Concerta, right after noticing my moods and mostly my anxiety levelling off. It wasn't like depression though, because I wouldn't stay sad. And again, it seemed to happen right around the midway point of the month. (I'm on the pill, so it's easier for me to keep track.)

The main thing about depression is that you will stay down where normally you might bounce back. Definitely talk to her doctor - especially where her lack of appetite is concerned. But also monitor how she's feeling over the next couple of weeks when her period ends. I have found in me, that this sadness is kind of an obsessive-compulsive thing, where something or things "shock" you (external or internal - say like a nasty comment or a jarring thought) and then you wind yourself up into a sort of spiralling bad mood until you get to the point of paralyzing despair. I think I know this cycle pretty intimately now... But it seems to me that if Concerta helps you focus, then it could possibly make you focus (or hyperfocus?) on what is troubling you to the point of obsession.

I've been taking a lot more vitamins since I made my original post and I've found this is helping a lot. I read online somewhere that what normally helps PMS (or PPMD, I guess is more accurate - thanks Greywulf) are the following: 200-360mg magnesium, 50-100mg b6, 400IE vitamin E, 1200mg calcium and melatonin.

So I take a regular multivitamin in the morning with extra b12 (every other day - mainly because I eat very little meat) - actually I would recommend a b-complex for your daughter. It did wonders for my stress levels when I was going recovering from a bout major depression. There's a brand called Stresstabs and I think I might start taking those instead of just the b12. I'm also taking iron supplements along with omega 3. At night, I've also tried the occasional melatonin to help with my sleep problems (which have also started up again this past half of the month) and calcium-magnesium supplements (which are better to take at night because they can make you sleepy.)

I know this sounds like a lot, but I will probably scale these back over the next few weeks/months when I figure out what works best. Another thing I found has helped is cutting off my coffee intake. I was only having one a day before, but then I was so woozy and nauseated I couldn't eat anything for the rest of the day. That has made a huge difference on my moods, too. So consider this if your daughter's caffeine intake and make sure she eats - because your brain needs food to function properly. I've had to buy a lot of "treats" for myself just to make sure I get something to eat. A lot of times I will get halfway through a meal and just can't force the rest down. (This also seems to be worse in the last half of the month.)

Also, my doctor told me that exercise is one of the best things for PMS/PMDD. I was already planning to do this, so lately I've been taking more walks (working my way up to running) and plan to take yoga classes as soon as I can afford it. I also find I do a lot more housecleaning this time of the month to deal with all the excess energy.

I did pick up the Sari Solden book, which is so good, that I forget to check out the chapter on PMDD - I've been jumping around in true ADD fashion, reading the chapters on work and relationships -- plus I've been really busy this week. That also helps take my mind off feeling yukky. :) Anyway, hope some of that is of use - sorry for such a long post.

Quote

Quote:

ameranda said: This is my first time to go on a forum about my daughter. She is 12 and has dyslexia and ADHD. She has been on Concerta for about 18 months. It does seem to help, we call it smoothing her out. However, we have seen a definite sadness in her the last few weeks. She just wanders around aimlessly and can't name what is bothering her. Then last night she just burst out crying at the dinner table and has been crying ever since. She still can't name what is bothering her, she doesn't want to eat anything and couldn't go to school today because she couldn't stop crying. She is also having her period this week. (She has had her period for almost a year.) We do have depression/bi-polar people in our family tree (diagnosed and un-diagnosed). I will call her doctor, but we currently just see the pediatrician for her meds. I am wondering what anyone else could recommend for us. I will not give her anymore Concerta until I understand what is going on. Thanks for anyone's thoughts or suggestions.

Ameranda, Not giving her any more Concerta may make this an even worse situation. Let me explain why by example - my own.

I am now 50, recently diagnosed as ADHD, and only just on Concerta for less than a month. I began my period when I was 11, and the rollercoaster of emotion began.

At any given time, I could cheerfully invite friends over for an afternoon of fun, and by the time they arrived, I'd gotten my period and wanted to slam the door in their faces, and scream at them to just go home. I went through horrible rages, some of which I buried so deep I only just started to remember them when I started to realize what had been happening to me earlier this year.

I also swung to the other extreme, where I'd start to giggle, the giggle would be come a laugh, and then next thing I knew I was on the floor laughing so hard I could bearly breathe. (It didn't help that my brother and sister would sit there and crack the worst jokes ever and I couldn't stop laughing....)

I'd also dissolve into tears without warning over just about anything. I still do at times - especially when I've got my period. I can't watch the news, because I find it heartbreaking and angering. During my period I can't watch sad movies, or I'll start sobbing at the first hint of something sad.

According to the doctor who diagnosed my ADHD, we are also prone to be more sensitive, not just emotionally, but some ADDers and ADHDers are more sensitive with their senses, taste, touch sound, vision, smell may have an even stronger effect on us. In part I'd suggest that this may be to allow us to get the stimulation we need because we tend to crave it more than others. (Hence the reason treatment for ADHD can be with stimulants.)

Most of this evened out as an adult, as my cycle and my hormones leveled off. What added to the balance was going on the pill to actually regulate my cycle. Before the pill, 8 days heavy flow, with a cycle anywhere between 38 and 52 days between periods.

I'm generally at my worst when my estrogen is down - which is what PMS and PMDD is caused by. I'm currently in perimenopause, and consider it an ever increasing PMDD - almost all the time. For me, the way I felt 3 almost 4 years go was like being angry 24/7. I couldn't talk to anyone. The stress was unbelieveable.

It was so bad, I didn't even worry about how others felt about my outbursts and temper because it terrified me. I felt like a car out of control. Picture you as a driver, your body and mind the car - and you're trapped in the back seat with no driver behind the wheel and the car is moving at a breakneck speed. That is what I've been experiencing for the first part of the last few years. I managed to find something that helped me level off - soy isoflavones which is a plant based suppliment which has a similar but weaker effect than estrogen (also called a phyto-estrogen). Believe it or not, it helped curb the tempers significantly. Concerta only helped me further by clearing my mind from the chaos that reigned there.

All because the dropping estrogen was causing PMDD - and that in turn was emphasising the ADHD. Yes, the lack of estrogen will make the ADHD worse (or at least even more noticable).

If as you say, your daughter has had her period for an entire year, with no breaks, its not a cycle. She needs to go to a specialist immediately. If what you meant to say is that she started her period a year ago, and when she has her period, she's more emotional, and at this time its a sadness bordering on depression, then I'd still say she should see a specialist, not just a pediatrician.

There are several factors here, and unfortunately, if she is like me, the earlier you can get the hormone factor calmed down, the easier it will be for her, and for everyone around her. As a plea from someone who's been there, done that, and doesn't want to remember it - help her to have the most normal of teen years. Her teens would be hard enough if she were like most other teens, but if she's like me, and it isn't controlled both hormonally and with the proper meds for the ADHD, it could be hell. Both for her, and anyone around ground zero.

One other "wonderful" note, if her hormones are the cause of this, and it is a lower estrogen level, she may also be prone to migraines. (Just read that in the papers today, and I get them everytime I have my period...)

Quote

It turns out, that through a sleep study, I've found out I'm "rousing" 20+ times an hour at night (yes, an hour, not over the course of the night). Due to some of the events (rages) from my teens and early 20's, I'm having flashbacks during the day, and the doctor suspects that I'm still processing everything and this is causing the sleep disturbances, although it could also be a cronic pain symptom. The problem is, I know I have a high pain tolerance, and tend to view most discomfort (ie pain) as background noise. That may have to be dealt with yet.

I've been referred back to the sleep clinic for a consult - psych consult, to discuss these issues. My general practicioner <sp?> has also suggested hypnotherapy as a possibility. Anyone with any experience with hypnotherapy, please sing out - I may investigate that path, but I'd like to know what to expect.

My cousin (also an add'er) says this all sounds like post traumatic stress, esp. because of the flashbacks and nightmares. I've had a few nightmares I couldn't shake off and ended up walking the apartment to try to get out of that mindspace.

If only I'd been diagnosed as a kid, I more than likely would never have had to go through the worst of this.

Quote

I've had some experience with hypnotherapy when I had hit a wall in regular therapy and wasn't getting anywhere. (..plus my therapist was always too eager to prescribe medication and I wanted to try something else.) I found it did help in the short term, but wasn't a real substitute for long term psychotherapy or counselling. I think it definitely would be more effective in your case when what you're trying to address is more physiological in nature (sleep disorders). It's supposed to be really good for quitting smoking or overeating. You may need several sessions for more deep-rooted issues. Especially if you think there's post-traumatic stress involved.

At the time I also underwent EFT (Emotional Freedom Technique.) When you look it up it sounds like hokum, but I found that made more of an impact on me than just the hypnotherapy. Could be a sort of "placebo effect" or just the benefit of becoming more aware of your emotions- but whatever it was, I felt a whole lot better afterwards. It could be that using both EFT and hypnotherapy together was more effective than each on their own. If you're in the Toronto area, I can give you the contact info of the person who treated me. For more info, wikipedia has a good overview about it: http://en.wikipedia.org/wiki/Emotional_Freedom_Technique

I didn't have many sessions though, because I didn't have much money at the time. So I had a fewer, but longer and more intensive sessions. Also, I had some reservations about continuing this line of treatment because I found it too tempting to continue indefinitely rooting through the past and overanalyzing my situation; rather than make the necessary day-to-day changes that would help me move forward. I guess there's no right or wrong way to heal; you just need to know what feels right at any given time. Overall I’d recommend this approach if you need to try something new.

As a side note, I just noticed that my new doctor has a number of certifications in hypnotherapy. I'm not using it at the moment, but I wonder how much of my treatment is influenced by this experience... Currently I'm coming at my treatment from a cognitive therapy angle. My thinking is this: hypnotherapy (and maybe psychoanalysis?) is good for uncovering previously undetected, subconscious workings; but real rehabilitation comes from any long term therapy that allows you to you work through the discoveries you find from the former method.

Also, wrt your sleep problems: have you looked into melatonin supplements? I've found those really help regulate my sleep cycles when I need them. They won't get to the root of the problem, but if you're looking get a good few nights rest (who couldn't use that?) then it might be worth trying.

Quote

Jess,

Thanks so much for your insight. It has definitely given me food for thought. I am in the Toronto area, so your info would be of great assistance.

I have had psychotherapy before, during my 20's (after most of the worst of the rages had passed). It turns out, that therapist is actually starting to specialize in Adult ADHD (this according to the therapist who did my assessment). I have a known and trusted resource at hand, if I need to go down that path again. I have no qualms about talking with her at all. It would be interesting to see how it would work this time.

On a side note, I am currently taking melatonin, but the nutritionist, who asked for the sleep study and is the lead phsycian for my ADHD treatment, said it doesn't always work, and there may be other things that may work better. I think he wants to see how the consult goes before we go further down that road. I do find it interesting that my life is starting to look like a deck of cards - that I'd been building into a house of cards and it collapsed. From his POV, he's trying to help be build a solid foundation, so I can move forward and get all the cards in the right place and the struture will remain standing.

The melatonin doesn't so much help my sleep cycle, but it does help make me less restless and I find it easier to fall alseep. If I get up during the night, I don't have any issues getting back to sleep, so I am getting more sleep, just not the quality of sleep I need.

Quote

Just thought I'd check in since it's been quite a while since I started this discussion. I'm still taking the Concerta, but in the process of lowering my dose - since I've lost a fair bit of weight and I am starting to get a handle on my ADD in general... (side note: what a relief!)

Anyway, I've switched my birth control a couple of times, and found one that's much better for my moods. So I think that might have been part of the problem. In fact, I think that might have always been the problem since I've always have issues with depression and found in the past that going off the pill altogether made a difference. However, at this point, it's better to be on it and luckily I've found one that agrees with me.

Quote