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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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For most my life ive been struggling to get even the most basic

Resolved Question:

For most my life ive been struggling to get even the most basic things done every day( like take a shower, or brush my teeth) Let alone try to make my business apts or take care of the various tasks that need doing in a basic and timely manner(im 27 now). I know i have to do these things, but no matter how hard i try its a struggle every day. I also have anxiety in social situations even amongst close friends, as well as a problem with an overactive libido(to the point that it makes me uncomfortable to be around people, or i sometimes say things to my female friends or customers(cringe) and an impulsiveness that seems to be tied to it.

Well, for the last month or so i've been taking adderall xr 20mg twice a day or 10mg ir tab 4 times a day, depending on whats available and at significant cost(mostly covered by the fact that im no longer impulse buying online). This has relieved some or eliminated even some of my symptoms. i still have some trouble getting things done, but its at least become manageable enough that i dont feel like im constantly struggling all day long, or embarrassed/ashamed i can't even get myself together. I'd also like to note, that i dont consume any other substances except tobacco, and i replaced caffeinated drinks with bottled water when i started taking adderall.

Thing is, i really dont like self medicated with drugs bought off the street, esp with the nature of adderall being a fairly dangerous drug. I'd really like to work with a psychiatrist/therapist if i could get one even reasonably close. The only nearby place is closed most of the time and it doesnt seem like they check messages. Ive been looking for a few weeks now, since i can finally afford to see a psychiatrist and therapist, because i havent had insurance since i was a kid, but i just cant get far enough out of the area to find a legitamate doctor. I really dont want to give up the adderall and go back the way i was, and i really dont know what to do.


Some brief background info. Im 27 M 190lbs 6ft 1in. I have some issues from a TBI(got hit by a car) that caused me to have some perceptual/emotional issues aswell as 50% loss of hearing in one ear, fine motor control difficulty, and sometimes drooling(it was really bad for about 2 years, but rarely ever happens to me now.) I'd also like to note that part of my difficulty with getting basic things done, comes from having lived on the streets as a child and having been beaten/abused until my father finally got custody of me and my brother when i was 10.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Mark replied 1 year ago.

Hi! You know, to give you the best answer, I think I should ask you a few questions first that will help define the problem and the situation.


It sounds as though you would have no problem getting your doctor to prescribe Adderall based on your symptoms and success with it so far. Can you explain what you mean that you just cant get far enough out of the area to find a legitimate doctor?

Do you have insurance now? Whether you do or don't, are there no doctors in your area?

You've had a lot of life issues that have exacerbated the ADHD problem. Have you had any psychotherapy?

Are you getting any treatment right now? If so, what type? How is it going?

If not, when was the last treatment? What type of treatment was it? Was it helpful?

Are you interested in psychotherapy?

Any extra information that will help, feel free to share.


Dr. Mark

Customer: replied 1 year ago.

I Live in a hyper seasonal tourist area, so ive only got about 4 months of the year to make all the money i can, so it'd be incredibly difficult to go(closest legit psychiatrist/therapist is about 2 and a half to 3 hours away. It would be incredibly difficult if not impossible for me to get away for 8-10hrs or more.


 


There are a ton of doctors here that are constantly going in and out of buisness, and mental health places have always been in very short supply to begin with. Pretty much everyone has to go out of the area in order to get any kind of regular mental health treatment. My regular doctor is a little over an hour away, and we just got a pharmacy this year in the next town over.


 


I dont have insurance, and probably cant afford to even go(even though im ready to spend it anyway because i need to)


 


I havent had any kind of treatment since i was a teenager, and pretty much all of it was ineffective. I have been on about 20 different medications before including, Lithium/zyprexa/zoloft and most recently(about 6-7 years ago) effexor xr. Other than the effexor, pretty much all them had such bad side effects you never even would of known if they did anything or not and to some degree i dont even remember what happened for over a year due to the debilitating effects.


 


Much of my "treatment" consisted of my dad and step-mom talking to doctors and nobody really talking to me or allowing me to privately even talk about things that im mostly embarrassed/ashamed of, ect that have happened to me. Alot of that really scared me away from the mental health field.


 


I really dont know alot about the mental health field or even really what psychotherapy is. I really just want to live like normal people, and im really tired of keeping everyone and esp my friends(which i have quite a few of these days, and finally managed to assimilate reasonably well here) at arms length, so most dont know how hard things are. (small town talk is bad for buisness)


 


Im not really sure, what to add. I've been working pretty hard to get to where im at, and now i really just need help to keep going. I'm not really in any kind of crisis mode, but really this is the first time ive ever had any real hope of living a (semi-)normal life even.


 


 


 

Customer: replied 1 year ago.

Relist: Looking for any advice. Should i go talk to my regular doctor in the meantime, while I continue to try and find some proper Mental Health professionals in the area? What are the risks of taking Adderall daily? The safety of my body is pretty important too.

 

 

EDIT::Opened this up since mark is offline.

Expert:  Elliott, LPCC, NCC replied 1 year ago.
Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Dear friend,

I believe that I can help.

I do think that it would be wise to make an appointment with a psychiatrist. Reading over carefully what you have written, I believe that it is not ADHD from which you are suffering, but bipolar disorder.

Bipolar disorder can be an an outcome of TBI and some of your symptoms are consistent with bipolar disorder (lack of focus, speeded up psychomotor reactions, high libido, reckless spending, and excessive and rapid talking - the kind that sometimes get you into trouble). Bipolar disorder can also make you feel down, and this can be relieved by the amphetamine and dextramphetamine in the Adderall.

Sometimes a person with Bipolar Affective Disorder (BAPD) is misdiagnosed as having ADHD and is given Adderall which creates euphoria and confidence by stimulating the reward centers. Someone with can feel better in the short run by taking Adderall which temporarily boosts confidence and makes you feel happy, but which can lead to addiction and dependency.

While the euphoric feeling of taking amphetamines is similar to those feelings in the manic stages of BAPD, if can make you anxious and distort your ability to perform with clear thinking and organized mind.

If you cannot get to a psychiatrist, talk to your local doctor and tell him your symptoms and see if he thinks it is ADHD or Bipolar, and if he is willing to give you Adderall, or something else.

Adderall is sometimes used as an adjunct for depression, and if this helps you with your depression or keeps you in a steady state, then the doctor may wish to prescribe it for you. Because it is a controlled and sought after substance, you are more likely to get relief from a psychiatrist if he or she finds it appropriate.

You have lots to consider, but seeking a professional, face-to-face assessment is the only way to go.

I wish you great success.

Warm regards,

Elliott, MAE, LPCC, NCC, CCMHC
Customer: replied 1 year ago.

i was once diagnosed and treated for bipolar. The combo of drugs they gave me, lithium/zyprexa/zoloft and some others caused me to become extremely violent(crazed/murdurous) and some extreme weight gain after just a couple months. Only time ive ever had a violent outburst before.


 


Im really not stuck on Adderall at all, its just the only thing ever worked for me, and one of the few i didnt have a serious reaction too. I just really hope i dont get run through a gambit of different things again. A stay in the hospital after a bad reaction, is a pretty scary prospect i dont care to repeat.


 


What do i do if i cannot obtain the records of everything i've taken and other stuff? I very highly doubt my dad has saved anything over 10years later.

Expert:  Elliott, LPCC, NCC replied 1 year ago.
Dear friend,

I agree that if a medicine is truly helping you then it is probably indicated. It is not unreasonable that you would want relief nor that a doctor would give you relief. However, the shadow the DEA frightens many doctors and makes it more difficult for them to prescribe meds that they otherwise would.

That is what you have to face realistically.

If you cannot obtain records from the doctors' offices, then your new doctor will have to consider your recollections. Because of HIPAA laws protecting patient privacy you will have to sign a release for each doctor so that they can forward your records to the new doctor.

- or you can obtain them yourself, probablly in person.

There are two things to consider: there are overlapping diagnostic criteria for ADHD and BAPD - AND - it is possible to have both of these disorders at the same time.

One of the most hopeful medications for this duel diagnosis is a wonderful antidepressant called bupropion (Wellbutrin) which not cause weight gain or lower libido.

Look at this article for encouragement:

http://www.webmd.com/add-adhd/news/20030711/adult-adhd-bipolar-disorder-may-overlap

and show it to your new physician (or even family doctor).

I shall keep you in my prayers for success and relief.

Warm regards,

Elliott
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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