Have Mental Health Questions? Ask a Psychiatrist Online
Hello, I am Rafael. Thanks for asking your question - I'm here to support you. (Information posted here is not private or confidential but public).
I am sorry to know about these disorders affecting your life, but feel very hopeful because of the significant improvements you have already experienced with medication and counseling.
Adderall is mostly used for ADHD and the fact it's been working that good for you, not only providing relief from ADHD symptoms but also from depressive mood is very good. It does show that medication is effectively creating a balance missing because of the ADHD and as most stimulants, helping you to improve your mood.
You are wise planning to get a complete psychological evaluation for ADHD. Depending on the professional's expertise and experience assessing people with ADHD, she/he would be able to develop a initial diagnosis after first assessment including interview, clinical history and testing. You need to be aware that for this evaluation to identify these or any other disorders, it would be necessary for you to stop psychoactive medication as recommended by professional before evaluation, in order to avoid problems identifying symptoms and impact on psychological processes, mood and functioning because of the numbing effect from psychiatric drugs.
Thus I suggest you to get in touch with a clinical psychologist with expertise in ADHD , depression and mood disorders and get initial recommendations for you to be ready for necessary psychological evaluation.
I am currently seeing a therapist - I have an appointment with a psychiatrist that specializes in depression and ADHD February 26th. I just get frustrated sometimes because there is a lack of good mental health care in our area - I have to drive an hour away to see the psychiatrist and most of this information is research I have done, and brought to the table to my doctor, not the other way around. Frustrating.
Answering your second question, you are right, depression could easily lead to problems in different psychological processes, including attention, concentration, memory and others, thus it could be more challenging to identify ADHD from ADHD symptoms caused or triggered by depression, but with adequate evaluation of present and past mental health and mood status, and functioning, professionals would be able to get to develop a good diagnosis. Please take into account that every mental health assessment-evaluation is a process, that starts with initial interview and testing, and continues with next sessions where professional continues to explore, identify and understand your experience, and it is from there that an official diagnosis is set.
Also, when I had psychological testing done in the past, they did not have me discontinue depression medication. Is that not normal?
I do understand what you say because of my professional experience, but only you know how frustrating it is to be in your shoes. Sadly mental health systems in many places lack a lot of even core requirements to be able to offer sound, ethical and competent support. That's why people need to take initiatives and literally push the system and look for expertise in order to get support they need and deserve.
ideally when a person is assessed in order to diagnose a mental health disorder, psychoactive drugs should be reduced or discontinue only with psychiatric support and monitoring in order to better identify all or most symptoms affecting the client. There are exemptions like in those cases where stopping medication for a couple of days would deeply undermine or set a high risk for deterioration of mood or functioning, because of the seriousness of the mental health problems the person suffers, but if that is not the case, it would be worthy to consider it not only in order to get accurate diagnoses but also for therapeutic work.
For example people suffering of depression but numbed by psychiatric drugs, could not do effective psychotherapeutic work because of inability to experience, explore, identify and learn to better cope with painful feelings, those numbed by drugs. this is why many times we could suggest clients to work with psychiatrists in order to reduce or even suspend medication for certain periods of time.
Once you get assessed for ADHD, you would better know what you need to work on, treatment options and from there professionals would develop a new treatment plan consistent with clinical findings and your reality, expectations and needs.
Does it make sense?
Yes, although I take 20mg of Lexapro daily, and I definitely don't feel "numbed" by it, in fact, that is why I am seeing a psychiatrist, along with the ADHD testing, although I understand where you are coming from. I don't think discontinuing those medications is an option for me at this point, because I would not be able to function without them and I have 3 children to take care of! But I am sure I will have more answers when I see the psychiatrist. Thank you for your answer.
Absolutely. I support you. I used the way numbing meaning the power medication has to reduce or eliminate symptoms, and as you just confirmed, it's obvious these medications have significantly helped you to take good care of yourself and of your loved ones, which is truly good.
I do feel hopeful you would be able to create and enjoy an even better health and life quality once more aware of the conditions affecting you and from there through consistent therapeutic support. Thank you for your trust.
I am sorry, could you please provide feedback about your rating as "poor service"?
It is my goal to provide professional support to every customer, and would like to know how I could support you better.
I was a little disappointed that you just exited the chat after you typed your response without giving me a chance to finish reading your last question or your response! And the way your phrased a couple of things I guess was a little off putting.
I am sorry, but I have not left the chat interface at all. What could have happened is that the chat interface disconnected you or presented technical issues, which use to happen here, giving you the impression I left, but I can assure you that I have been here from the very beginning and not left. Chat records do show it.
on the screen it said you stepped out of the chat and on the upper right side of the screen it said you were not in the chat, as it did next to your profile. if that was not the case I apologize.
I respectfully XXXXX XXXXX to reconsider your rating since I do not have any control whatsoever of the performance of the chat interface, and it was not my intention to phrase ideas in any disrespectful or unprofessional way.
I can assure you that I have remained in the chat from the very beginning to this moment, and I invite you to contact JustAnswer if you have any doubts about my statements. I am sorry that the technical problem with the chat interface gave you such impression, it does happen many times, and site's management is aware of it and continues to work on fixing such problems.
That's fine. I guess the other issue I feel offended with is your use of the phrase numbing in regards XXXXX XXXXX antidepressant. It doesn't numb anything for me. Technically, the Lexapro is supposed to correct the Seratonin imbalance in my brain. I understand that you were trying to say I suppose that the medication was reducing the symptoms of depression or ADHD, but honestly, it needs to be phrased better. I can change your rating, but you might want to think about going forward, because people that are struggling with mental health issues - these issues are a big deal. Life affecting big deals. Before my doctor put me on Adderrall I wasn't hardly functioning. It is life consuming and we are looking to you - the expert per se for advice, and how you phrase things is important.
I agree with you and apologize for not using the right words to address the idea I wanted to communicate, this is why I clarified what I meant once you told me about your experience. It is through adult and respectful dialogue that we all can better understand each other and get something productive from any exchange. Again, I do apologize for not using the best words to express my ideas on that specific point.
I was actually very glad and hopeful when reading how well medication and counseling have been helping you to feel and function better, and I tried to express that through my replies. I truly hope these next steps do promote further improvements in your integral health, well-being and life.
Thank you. I appreciate your dialogue. I hope to continue to improve and hope to get the correct diagnosis after seeing the psychiatrist so I know what issues to tackle, I think there are a couple. I appreciate you help and will adjust your rating.
Thank you for your patience and understanding. I hope you get the best possible support to develop the life and well-being you need and deserve. Take gentle care.
Thank you and you as well.