Reply To: Medication losing effectiveness

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wwintels
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I’ve experienced something similar. I was diagnosed as having ADHD at 50, along with the anxiety that accompanies having to compensate for impaired executive functions for 30 years of adult life. I was tested for OCD as I have some of the symptoms, but they appear to be mostly the result of the hyperfocus that sends you down these compulsive ADHD rabbit holes. After several months of CBT that was only somewhat successful, I finally reluctantly started with generic Ritalin with the goal of making the CBT easier. The positive effects were very evident in the first two weeks; I was able to focus on conversations better, better able to organize tasks without getting overwhelmed, able to get more done, and as a result I was able to sleep better at the end of the day. I was very conscious that this may be “wishful thinking”, the “placebo” effect, or just ramping up the CBT and mindfulness efforts due to being so heavily invested in the therapy and really wanting it to work. After this, the doctor increased the dose of Ritalin which just ended up turning the frustration I constantly feel with the ADHD into outright anger. In otherwords, it seemed that the stimulates intensified negative emotions, anxiety and frustration and put my entire nervous system on edge, which negated any positive effects. Same happened with Concerta, so I moved on to Stratera, which did nothing. Increased the dose of Stratera, but by now, I’ve fallen off the CBT, and I’m starting group therapy in September, so I’m holding off on the increased dose until I can get back on track with the CBT and have the progress monitored by the new therapist.

The internet, coffee and food are my compulsive coping vices. The internet is a tough one because I need it for work and the rise of social media has made it even more addictive and distracting, but the coffee and food I try to replace with a Soda Stream machine that stands between my coffee maker and the fridge. I find the soda water stimulates my brain more than regular water, seeing the machine there acts as a cue to use it as an alternative, and and that the simple physical preparation replaces the nervous habit of making another pot of coffee or raiding the fridge when I go there. The idea is to replace the bad habits with a more benign benign one. I sweeten it with boxed fruit juices to add variety to the flavors and avoid the sugary syrop and artificial sweeteners that come with pop drinks and caffeinated beverages that Coca-Cola and Pepsico are trying to overstimulate us with. Maybe this could replace the flavors, the routines, and associations yo have with alcohol if you drink at home.

My next step is group therapy with other adult ADHD people. I’m hoping that this will supply more support than I’m currently getting from my doctor and past therapists (there’s only so much I can ask for from my wife). I haven’t had a therapist yet that specializes in adult ADHD, and I know that everywhere I have facetime with an ADHD sufferer that has this under control, I feel more motivated with the CBT. If you drink in bars with other people, maybe alcohol-free facetime with others will replace the companionship and social inhibition

With the anger and hopelessness, I just make sure it doesn’t turn to despair and understand that what ADHD people are up against is difficult but not insurmountable. We’ve survived this far, it hasn’t been easy, but we’ve been doing some things right. Emotional challenges like aging parents have tested your weak executive functions and made it even harder to cope as you were literally rewiring your brain and it has probably put you back a little. Unfortunately, the science wasn’t there when we were going to school and we weren’t given the training when we were young to deal with it, but it’s rapidly advancing now, so we’ll slowly figure out what else can be done. This is a longterm life project that will require managing ourselves from the time we get up in the morning to the time we fall asleep, something that does not come easy to us, so we’ll fail quite often, no matter how we try. We’ll have to forgive ourselves for that. The medication may make this management easier, but it may not. In either case, it works for other people and the payoffs are considerable, so it’s worth trying.