Reply To: ADHD with/or SPD?


“…constant bombardment from my senses makes it impossible for me to think critically and clearly, and the
physical and emotional strain of always guarding against sensory input is exhausting.” (Laura1974)

Frequent, if not constant, bombardment by thoughts not related to the task at hand, being very distracting and even disruptive to functioning, is a very common symptom in ADD, as is impairment of executive functioning, cognitive functioning, etc.

It is also not uncommon for those with ADD/ADHD to have some symptoms of OCD (or depression —see below) also!! With adequate treatment of the ADD/ADHD, many of the OCD symptoms and the depression disappear or greatly decrease. If the depression is because of the ADD/ADHD, the antidepressants won’t really ‘fix’ it, because the cause of the depression is still there, until that is treated! (see below)
The gold standard for treatment of ADD/ADHD is trials of the central nervous system stimulants, which come in various release forms (immediate release, extended release, capsules, tablets, liquid, patch, etc., etc.), in the 2 major central nervous system medicine groups (methylphenidate —like Ritalin, Concerta, Metadate; and dexmethylphenidate – Focalin; and several dextroamphetamine – like Vyvanse: and mixed salts of amphetamines (e.g., Adderall, Mydayis). There are many different ones out there, many generic now, some only brand name, each with some differences in length of action, and other differences.

You (Laura) didn’t mention what the specialty is of the doctor you see. It’s worth just keeping in mind that until about 10-15 years ago, ADD/ADHD was considered “a children’s disease” that kids “grow out of” (NOT!!) and even psychiatrists who did not also subspecialize in child and adolescent psychiatry, but only treated adults, were not even taught about the presence of ADD/ADHD in adults!! Ten years ago, I knew a mom who took her 16 year old daughter to her pediatrician’s appointment to get her ‘regular’ refill of her ADD medicine, as they had been doing for years with successful results, and the pediatrician shocked the mom by saying he could no longer prescribe the ADD medicine for her daughter, because she was “now an adolescent” and kids grow out of ADD/ADHD once they reach adolescence!! Mom was panicked, frightened for her daughter, found a child psychiatrist, and the girl’s medicine was continued, and her grades went back up, mood improved, etc.!!

It’s very common for the major complaints of college students and adults being referred for evaluation, to be “depression and anxiety” or “anxiety and depression.” For many of those, they are found to be struggling for years with undiagnosed and untreated ADD or ADHD!! Their depression was “due” to their struggling to succeed, knowing they are capable of doing better, but not knowing “why” they continue to do poorly, not knowing what’s “wrong” with them, whether in school or at work, becoming increasingly hopeless and feeling they are a failure, and the anxiety increased because they become increasingly afraid they will fail the exam, and the next, and the next, not get the project (or homework) done in time, etc., or mess up at work and get reprimanded or fired, etc., because they couldn’t perform as well as they ‘knew’ they should be able to. For those who end up actually having undiagnosed ADD/HD, these symptoms disappear or become greatly reduced once they are on the right dose of the right ADD/ADHD medicine, and they then become ‘functional’! (and very often do not need to continue taking the antidepressants)

Laura, if your doctor isn’t knowledgeable about how to diagnose ADD or ADHD, or how to treat it, it might be worth making a trip “to the big city” to see someone who is experienced and knowledgeable about ADD and ADHD in adults. Once diagnosed and started on an effective medicine, perhaps you local doctor would be willing to follow you and prescribe your refills, etc.