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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5220
Experience:  Dr. Mark is a PhD in psychology in private practice
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Ive always felt like I had ADHD before I was diagnosed, a

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I've always felt like I had ADHD before I was diagnosed, a disorder that involved hyper activity, Not being able to remember to do things, not wanting to go to school much less do school work, and church-having to sit still and listen makes me sick days before thinking about it. I get distracted and lose track of time not being able to finish work.
I hate church, but I believe and want to go. I can't force myself to go. I can't finish tasks at work, I do engineering / design work in cad but I can't get projects finished, and even though I'm very good at it, I can't get projects finished in time because I get lost in the details.
I just got diagnosed as having ADHD by a psychologist suggested by my insurance, but they don't prescribe medications for it so they referred me to a psychiatrist. I set up an appointment but I don't know what to expect and I'm having anxiety not knowing what to expect.
Question: Is there a type of medication that can help me make myself go to church, and focus finishing my projects and stop forgetting where I put work/projects I'm not currently working on? If so, are some types better than others? I've looked at alot of different meds including differences between things such as Vyvanse and adderall(sp?) If I get prescribed a non amph is it as good as Adderall, vyvanse or ritilin? Should I\Can I, request something different if I feel like another may work better based on the things I've read?

I'm 41, I've been struggling with my problem for a Long time and I'm really to the point where I don't care what anyone thinks or says anymore, I just need help, and from what I've read it sounds like even people my age are able to live a more normal life with the meds.
Background: Started getting in fights in school around 1st grade, but I was never the aggressor, but fighting was the one thing I always finished well. I'd feel bad after beating people up even though they started it. I started getting suspended from school for things in middle school. I graduated from High School with a 1.6 GPA, C- average. I was able to talk a college into taking me(ofc I believe it was the prayer:) but even though I really wanted to impress them and show them I could do it, I still couldn't finish projects on time. I graduated from a college of engineering at a top university, but no happy ending there either, I barely had over a 2.0. Married, I lose my temper too quickly, interrupt too much, go into Too Much Detail...

I guess main things I wish I could do better are, with work, I can't finish projects, at home I can't finish projects or even start them. I want to get my explosive temper under better control. And I'd like to be able to force myself to do things like go to church or work related meetings.

Hi! I believe I can be of help with this issue.

I can imagine how frustrating and worrisome this situation must be for you. It is really amazing that with your history you were never diagnosed with ADHD as a kid (you're not that old so they were already diagnosing it when you were in school). And you seem to have rather severe symptoms even as an adult. So the frustration must be having to go through these feelings continually. The worry must be what the meds are going to do to you and the relationship with the doctor.

Psychiatry today is changing. It is becoming much more based on a high volume of patients. This puts a lot of time pressure on the doctors. So it is difficult to know if the one you have selected is of the type that conducts a rather cursory interview and then prescribes. Or if your doctor will be the type who is more patient and will give you more opportunity to discuss in depth your questions and your concerns.

Therefore, I recommend very much that you write down your questions grouped into areas of concern. And take a pad of paper with you to jot down notes. Many of the questions you've asked above you will need to discuss with him/her to get the definitive answer as he/she will be prescribing. Having your questions in writing will help you not get flustered if your doctor is one of the brusk and busy type of psychiatrists.

Now, the question of whether the meds will make you do what you want to do: no. There is no such medication. We are creatures that integrate into one whole unified being biochemical/physiological/emotional/cognitive/psychodynamic/spiritual parts. The psychotropic medications we have today barely account for the interaction of the biochemical/physiological parts of us. And they do that very generally, no specific to each of our unique characteristics. So what good are the meds?

They can give your brain function more ability to function in more "normal" ways. Whether one of the stimulants (ritalin and the newer ones) or a non-stimulant like Strattera would help in this more is going to be part of the psychiatrist's goals in the interview. And partly it will be a case of trial and error and adjustments.

So you will be going into his/her office and there will be an interview process. Again, depending on the doctor's style it will either be a more loose conversation or structured, with him/her asking questions from a checklist.

After he/she prescribes, you need to make sure you have asked how to tell if the intended effect is happening and what the timeline should be. And when to call if you are experiencing any other effects.

So that's the visit. Back to the meds, they can be very helpful in that they can help with the biochemical/physiological part. You then have to still work on gaining the skills you have a hard time with: organizational, non-impulsivity, anger management, spiritual fulfillment, etc.

These are YOUR individual work. And that you should do in psychotherapy with the psychologist. So make sure your psychologist is working with you on these issues. You can use my answer as a springboard if you like.

Okay, I wish you the very best!

Please remember to click the green accept button because: even though you have made a deposit, I do not get paid for my time unless you press ACCEPT. Feel free to continue the discussion as my goal is to get you the best answer possible. You can continue the discussion even after pressing ACCEPT. Bonuses are always appreciated! If I can be of further help with any issue, just put "for Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

Customer: replied 5 years ago.
Dr. Mark - I was never diagnosed because I never got tested for it until now. My mom still says I don't have ADHD, my parents laugh about pshycology of any kind. They think it's all in your head like hypochondria or something. Ironic huh... I think they both have ADHD almost as bad as I do and can't recognize it because to them, I'm not that different.

Back to the meds, yeah, it has me concerned, I want whats best for me, I don't want to be on something that I don't think is working, but do I have a say? For example, I hurt my back lifting weights in high school, I never went to the doctor for it. It took 6 months to stop hurting, I hurt it a couple of times since then and it shut me down for weeks each time. I hurt it again a couple of years ago and decided to get pain medicine because it was really hurting me more than I wanted to bear. The doctor gave me some kind of muscle relaxers, and the shooting pains got worse, In my opinion, the tightened muscles must have been holding something together and the muscle relaxers let the damaged joint slip further. So, I asked him three times for pain killers, each time I got something that didn't work, finally I got mad and went to a different doctor and I got what I felt I needed, and It worked great. I was able to take just the amount that I felt I needed to bear the pain, and within a month I was off the meds completely.

That said, will I have this kind of flexibility or will I be forced to take what the psychiatrist thinks I should be taking?

I was also concerned about the Long Term effects of Adderall. I would rather be on a stimulant one, I take aspirin for headaches sometimes. I would never take tylenol because it's bad on the liver, and it worries me. I feel like damage to the stomach is less severe than liver damage. So, I don't trust nonstimulants. are you familiar with long term hazards? Why, can't I just go on Adderall for the rest of my life if it works for me?
There are a couple of questions here, so let me address each one in order.

The doctor/patient relationship today is changing very much. It today is based on a joint effort. You have to be proactive to make sure you are getting what you want. You seem to have seen how that works in the last few years. So, you'll judge in the initial interview if you feel comfortable/confident enough in this doctor to start off with his/her prescription. If not, then you'd say thank you and that you're going to get a second opinion. The doctor may be offended, but that's the way it is.

If you are confident with the person, then you'll ask him/her all your questions about the meds. Stimulants are very interesting in that they work differently with people with ADHD than with people who don't have ADHD. With ADHD, they do the opposite of what they sound like; they help the person's brain slow down the focus. That's the effect you're looking for.

We don't know why sometimes meds stop working after long periods of time, 20 years sometimes. We don't know if it's hormonal changes in the person, environmental factors, or other factors. Most likely, a combination.

But the problem you seem to be referring to in your other question about why you can't just take the med your whole life is because of the warnings. You know the FDA warnings are both useful and an impediment. Any one warning may refer to anywhere from 25% of people taking the medication to .025%. That is thus only a guideline. You have to decide: if it talks about the chance of liver damage, for instance, what is better. What do I mean?

Meds are a risk/benefit ratio question. You're an engineer, so I think you know what I mean. If your benefit is great enough, then the possible risk may not warrant discontinuing the medication. I know patients who have indeed been on a stimulant all their lives as adults. And when one stopped working as well, they've switched to a different one. They were lucky in that this worked for them.

So, you are embarking on a journey. You don't know what the answer will be yet. It will be a process. Let yourself go through the process rather than trying to anticipate in advance everything.

I wish you the very best!

Please remember to click the green accept button because: even though you have made a deposit, I do not get paid for my time unless you press ACCEPT. Feel free to continue the discussion as my goal is to get you the best answer possible. You can continue the discussion even after pressing ACCEPT. Bonuses are always appreciated! If I can be of further help with any issue, just put "for Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

Dr. Mark and other Mental Health Specialists are ready to help you
Customer: replied 5 years ago.
Dr. Mark,
Thank you So much for your time. You were very thorough and have answered questions and concerns I had, but was not able to put to words well enough for most people to understand.
I'm really sorry about taking up so much of your valuable time, but I was really concerned and you've helped me tons.
Thanks Again
I wish you the very best. And I am glad that you treat your parents' having not gotten you the help when you were a kid with humor. That attitude counts for a lot in most areas of life!

Dr. Mark

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