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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7663
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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Adult ADD take concerta. Worried about growing clutter ( emotional,

Customer Question

Adult ADD take concerta. Worried about growing clutter ( emotional, intellectual, anxiety) that seems to be getting worse. I am 52. Still have my period? Can I blame menopause? How concerned should I be?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year ago.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

I believe that I can help.

Elliott, LPCC, NCC :

Mood changes, and anxiety are common in the perimenopausal period.

Elliott, LPCC, NCC :

Can you further explain what you mean by emotional and intellectual clutter?

Customer:

I have a hard time discarding things that I feel sentimental about.

Elliott, LPCC, NCC :

Physical things?

Elliott, LPCC, NCC :

Or just memories?

Elliott, LPCC, NCC :

Are you able to see my messages?

Customer:

I have a hard time discarding items that stir emotions. For example pictures, program flyers, newspaper clippings related to people and family, objects that remind me of things. I also love to read and learn. Former teacher. Home for 13 years raising two boys. My youngest will leave for college in the fall. I save books, articles, old teaching material, things that I feel have 'important information.' I have a vision of what I would like all of this to look like, and have areas of my life that are very organized like my calendar, bills, kitchen, etc... I have two rooms that look like they could be on an episode of 'Hoarders" If you met me or worked with me, you would have no idea that I had this problem. The problem has gotten worse in the last 4 years, and I do not have people over as much as I used to. I can still create an "illusion" downstairs that my life is put together, but upstairs is a mess.

Customer:

Yes, just saw your messages.

Elliott, LPCC, NCC :

Do you like to do things your way and have a tendency to be a bit stingy?

Elliott, LPCC, NCC :

Are you a perfectionist?

Customer:

Yes, I like to do things my way. Yes, I am a perfectionist. Middle child - not too stingy, not too competitive.

Elliott, LPCC, NCC :

Are you absorbed with details, lists, organization, rules or schedules?

Customer:

I used to be. Now just seem disorganized. More procrastination.

Customer:

More anxiety.

Elliott, LPCC, NCC :

The anxiety could be caused by the Concerta, actually.

Customer:

I have read that. It actually seems to help in morning. I feel calmer for awhile.

Customer:

I am very sensitive to many types of medicine.

Elliott, LPCC, NCC :

It seems that you might have a personality disorder called OCPD, which is obsessive compulsive PD, not the same as OCD. Let me show you the psychiatric manual diagnostic criteria and see what you think.

Customer:

OK

Elliott, LPCC, NCC :

Diagnostic criteria for 301.4 Obsessive-Compulsive Personality Disorder


(DSM IV - TR)



A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:


(1) is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost


(2) shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met)


(3) is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity)


(4) is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)


(5) is unable to discard worn-out or worthless objects even when they have no sentimental value


(6) is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things


(7) adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes


(8) shows rigidity and stubbornness

Customer:

No - this does not sound like me.

Customer:

Number 5 - yes

Elliott, LPCC, NCC :

And none of the others then? OK.

Customer:

What about an anxiety disorder?

Elliott, LPCC, NCC :

You may have general anxiety disorder. What about the collection of items upstairs? Why do you collect or keep them?

Customer:

Fear of forgetting, emotional distress it causes me when I have to start thinking about getting rid of items.

Customer:

Plan on using them. I am very creative. And do use a lot of the items for

Customer:

things I am in charge of - like fund raisers, decorating for parties (used to at my house - now just other places)

Customer:

Just talking to you about all of this - I can feel my palms sweating and my heart is racing.

Elliott, LPCC, NCC :

Does this apply to all of the things you keep or do you have difficulty parting with some things?

Elliott, LPCC, NCC :

That indicates anxiety reaction, which is uncomfortable for you but helping to understand what is going on with you.

Elliott, LPCC, NCC :

This is a mild form of panic attack, or a strong anxiety attack.

Customer:

I can part with broken items, trash, old clothes, things to donate or give to others in need.

Elliott, LPCC, NCC :

And one man's trash is another man's treasure.

Customer:

Yes, i feel like I am having those. Night time is worse.

Customer:

Ha HA

Elliott, LPCC, NCC :

I admit to having a lot of "junk" but I have a tremendous amount of space. LOL.

Elliott, LPCC, NCC :

I understand your reasoning.

Customer:

Most concerned with why it is getting worse.

Elliott, LPCC, NCC :

You may be doing a bit of hoarding. You feel you cannot let things go.

Customer:

Yes, family history of hoarding on my dad's side.

Elliott, LPCC, NCC :

It is a bit of obsessive compulsive behavior, not full blown diagnosable, but OCD is also an anxiety disorder and the lines between them blur and are not as distinct as you see on TV.

Elliott, LPCC, NCC :

Anxiety runs in families (genetic) and it can also be a cultural practice as well.

Elliott, LPCC, NCC :

Learned behavior and not just anxiety.

Customer:

I agree.

Customer:

I have had some big stresses in my life as well.

Elliott, LPCC, NCC :

Are you taking any medication?

Customer:

or "deaths"

Customer:

Concerta 54 mg in the morning.

Elliott, LPCC, NCC :

I am not a big fan or advocate of medications, but an occasional "circuit breaker' may be a lot better for you than Concerta.

Elliott, LPCC, NCC :

You have not said anything that implies ADHD.

Customer:

Would be interested in learning about "circuit breakers"

Customer:

I have racing thoughts - all my life.

Customer:

Fast speech.

Customer:

Very active - upbeat person in public.

Customer:

Poor impulse control at times - shopping, money, etc..

Customer:

In the morning when I wake up, I am often very anxious, feel overwhelmed. Take concerta and a

Elliott, LPCC, NCC :

That sounds like Bipolar Disorder.

Customer:

cup of coffee ( ha ha more stimulants) - then I have a window of about 3 hours that

Elliott, LPCC, NCC :

I think that Concerta is giving you the extra anxiety.

Customer:

are my best.

Customer:

What would you recommend??

Elliott, LPCC, NCC :

You are describing the symptoms of mania, very clearly.

Customer:

Bi polar 2? I have wondered??

Customer:

What can help?

Elliott, LPCC, NCC :

I urge you to talk to a psychiatrist about your symptoms and your current medication, and I believe that he will want to take a close look.

Elliott, LPCC, NCC :

Here are the symptoms of mania, one of the two poles of bipolar:

Elliott, LPCC, NCC :

Mania DSM-IV


A) A distinct period of abnormally and persistently elevated, expansive or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary)


B) During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:


1) inflated self-esteem or grandiosity


2) decreased need for sleep (e.g., feels rested after only 3 hours of sleep)


3) more talkative than usual or pressure to keep talking


4) flight of ideas or subjective experience that thoughts are racing


5) distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)


6) increase in goal-directed activity (at work, at school, or sexually) or psychomotor agitation


7) excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)


C) The symptoms do not meet criteria for a Mixed Episode


D) The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.


E) The symptoms are not due to the direct physiological effects of a substance or a general medical condition.


 

Elliott, LPCC, NCC :

You also have anxiety, but that may be driven in part by the Concerta, which has anxiety as a side-effect. I believe that the doctor will wean you off and give you very different medication.

Customer:

I had a lot of anxiety before Concerta. Tried some of the 'pam family" types of medication, like Lorazapam. Horrible!

Elliott, LPCC, NCC :

Concerta can induce mania as well, but you have had the mania before the Concerta, which may be making the situation worse.

Customer:

I feel like I can fluxuate between - highs and lows all in one day?

Elliott, LPCC, NCC :

I urge you to see an expert on psychotropic medication, and that would be a psychiatrist.

Elliott, LPCC, NCC :

That fluctuation is called "rapid cycling" and is difficult to endure.

Elliott, LPCC, NCC :

WHATEVER YOU DO, DO NOT TAKE AN ANTIDEPRESSANT AS THIS CAN MAKE YOU MUCH WORSE.

Customer:

I am worried about how it will afffect future insurance possibilities, etc.... public records.. also not a big fan of medication.

Elliott, LPCC, NCC :

So is not getting treatment a better option?

Elliott, LPCC, NCC :

It is not a pre-existing condition.

Customer:

Have been hoping to 'fix it' myself :0

Customer:

What do you mean by not a pre - existing??

Elliott, LPCC, NCC :

I am talking from an insurance point of view. If it is pre-existing they can deny the claim but if newly diagnosed they cannot. This would be in your favor.

Customer:

But what if down the road I needed to get insurance on my own?

Elliott, LPCC, NCC :

You could try controlling by yourself.

Elliott, LPCC, NCC :

Here are a couple of workbooks:

Customer:

I also worry I could not qualify for any long term health care/

Customer:

Do I need to write those down or will I have a copy of all of our chat in an email??

Customer:

I do think I need to see a counselor to talk about some past things that still cause me pain, as well.

Elliott, LPCC, NCC :

The chat will remain available. You can copy and save the chat. YOu can print it.

Elliott, LPCC, NCC :

That will help, I'm sure.

Customer:

I will research rapid cycling as well. Should I consider going off concerta? or taking a break?

Elliott, LPCC, NCC :

You may not be able to quit it cold turkey but wean it down slowly according to your doctor's or pharmacists schedule.

Customer:

Do you have any thing natural that you recommend to help relieve anxiety?

Elliott, LPCC, NCC :

Stop using caffeine by cutting down slowly.

Customer:

I feel like caffeine helps me think and feel 'happier". Kind of like the Concerta.

Elliott, LPCC, NCC :

Adding even natural drugs (such as St. John's Wort) would be harmful.

Customer:

Do you like any type of drug for someone with my profile?

Customer:

Just not a big fan of trying a lot of prescriptions to find the right fit.

Elliott, LPCC, NCC :

You should really see a psychiatrist who will give you a mood stabilizer or antipsychotic drug, or antiepileptic drug. These are what are given for bipolar disorder.

Elliott, LPCC, NCC :

The usual approach is trial and error within limits, since every person is different. That is why there are many medications.

Customer:

I am so sensitive to most medication and the warning labels etc... are ridiculous.

Customer:

I am thinking about starting yoga. Or finding a counselor that specializes in BCT?

Customer:

I had such bad reactions when I tried a few types of medications a few years back. That is when I

Customer:

started Concerta.

Elliott, LPCC, NCC :

You have many options.

Customer:

True and I feel stronger when I think about taking action. That helps my anxiety.

Elliott, LPCC, NCC :

You need a proper face-to-face diagnosis first and then you can choose your options.

Elliott, LPCC, NCC :

That is good. Positive thinking works for you. You are strong.

Customer:

I had to see a psychiatrist to get ok'd for "adult ADD" - he did talk about symptoms of

Customer:

bi polar type personalities. Said "maybe' with me - but was ok with

Elliott, LPCC, NCC :

of what?

Customer:

going with Adult ADD label.

Customer:

not sure what you mean? 'of what" ??

Elliott, LPCC, NCC :

You didn't finish your sentence when I wrote that.

Elliott, LPCC, NCC :

I wouldn't recommend going back to that psychiatrist.

Customer:

Ha Ha. That is how I feel about many of them here in Boise.

Customer:

I do feel strong right now and that I am willing to admit I "have some things to work on"

Customer:

Big step for me. And I am determined to change for the better.

Elliott, LPCC, NCC :

I urge you to take that positive energy and run with it. Make an appointment on Monday. You can make changes for the better. I know you can and I shall keep you in my prayers.

Customer:

Thanks so much. I will look into the books you recommended.

Elliott, LPCC, NCC :

You are very welcome.

Customer:

Thank you for your help tonight and your kind words and prayers, as well!!

Elliott, LPCC, NCC :

I am so happy to help.

Customer:

I will try "giving up concerta" some real thought and talk to my doctor about that as well.

Customer:

Thanks again!

Elliott, LPCC, NCC :

:) I wish you GREAT success.

Customer:

Thanks. Lots of change coming in my life and know I will need to be strong.

Elliott, LPCC, NCC :

You ARE strong.

Customer:

:)

Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7663
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
Elliott, LPCC, NCC and other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.

Thanks. I will let you know how I am doing.

Expert:  Elliott, LPCC, NCC replied 1 year ago.
I would be delighted to know, and pray for great news, KK. :)


Elliott

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