Without the medication I am unable to function

[Grant]

Last summer I was finally properly diagnosed with Adult ADHD (without the H, which is probably how they missed it.) Forever, I've been dealt the depression card and prescribed treatments (counseling and a horrifying array of medications that made things even worse).

Finally, the right diagnosis and the right treatment (10mg of Adderall twice daily) I felt transformed. I felt able to focus on tasks and not marinate in my depressive feelings. I could make plans and follow through. I could balance areas of my life, whereas before I let all my relationships (not that I actually ahd any outside the theraputic one with my counselor) and other junk go to see. I managed to finish my Masters degree, no small feat, I know. But everything else was tossed in service of that specific goal.

Then I lost my job, and my insurance, and while money was okay, it wasn't enough to, pay for psychiatric visits, particularly when my treatment team wasn't exactly top notch to begin with (it took them three years to figure out it *wasn't* depression).

I had already had some difficulty with my primary provider; he's staunchly against adderall and other stimulant medications, and while he was willing to prescribe them for one time, it wasn't enough time to find another psychiatrist. For the private payee, the wait for a psych is about three months, through the county, if you're not in acute crisis it's about seven or eight months. I live a very rural community where you just can't provider shop.

I do not have any addiction issues; I was very judicious with my medications, reported all my reactions, etc and did not abuse them. However, my primary care doc will not prescribe them to me.

So my life sits on hold. I have an appointment with a psych in October, the earliest appt I could get. I am not in therapy and most days I do not leave the house except to get money from the ATM and because I force myself not to drive and take a 30 minute walk around my neighborhood. This is in stark contrast to me last summer where I was writing, going to the gym every day, taking a belly dancing class, working and trying to let myself date, even though I'm pretty convinced that I'm too ugly for love.

Ironically, the thing my primary doc was most concerned about happened *after* I stopped adderall; dramatic weight loss. While I was certainly obese at 5'2/270 at the start of my treatment, within seven months i was at a comfortable-for-me weight 190 pounds. I was happy, fit and felt healthy, even though I'm sure I look quite fat to other. Since getting off the meds I rarely eat and am now 140, though I haven't weighed myself in a month or so.

I just don't know what to do. I have an appointment with my primary doc in two weeks, but it's just for asthma medications. The isolation and rapid decline of the quality of my life just makes it even harder to try anymore.

[Guest ASchwartz]

Hi Grant,

Before my retirement from private practice I worked with many adults with ADHD. I know from their experiences with insurance companies that, most frequently, the issue is not stimulant medications, but the cheapest medications. Many people who were denied Adderall were allowed Ritalin because it is very inexpensive. You should find out about that.

Also, ADD is usually accompanied by depression and it is common to prescribe an anti depressant along with the stimulant.

Finally, ADD is not just a matter of medicine. There are many self help books on the topic of ADD and ways people can help themselves stay focused. There are also some therapists and coaches who teach ADD people learn how to keep focused.

Allan

[Grant]

Well I paid for my scripts out of pocket, so I don't think that was a factor in my primary care doc not prescribing the medication. The self help books and anti-depression medications have been of no used to me, and I had a terrible reaction to Ritalin.

Thanks for your response though. Hopefully, I can make it through til October when I can be screened by a psychiatrist.

[Mark]

Grant,

I don't have much to add - but am wondering a few things

did you ask your primary doc why s/he would not prescribe you the medication? Was it a worry about not wanting to prescribe "specialist" medication, or was it actually a concern about addiction? I'm curious if you actually asked what the rational for refusal was, and if you explored any other options with that doc.

My second thought is that, though you may need to wait until October, maybe if you call frequently and tell the desk clerks that you will take the next available appointment and can they call you if there is a cancelation, etc. that maybe you can be seen sooner than that. It would seem worth going to that extra trouble if the difference between being on the right medicine and not is so dramatic (and if you have the time to jump on a suddenly open appointment). No need to passively wait. In some cases, the squeaky wheel gets the Adderall

[Grant]

My primary doc (it's a he) just "doesn't like" prescribing without the patient having a psychiatrist. Which kind of doesn't make sense to me, because well if I had one I wouldn't be asking him to prescribe it. I get that it's a lot better to do medications in concert with talk therapy, but at this point after three years with a really unskilled therapist, I'm not eager to resume talking to anyone else. There were some major cultural blindspots and I just don't feel like putting myself out there for a therapist who is so myopic.

Also, about twice a week I contact my prospective psychiatrist's office and politely ask if there have been any cancellations. I also have asked the receptionist to please contact me if there are. She put me on a list and let me know there are about 15 people ahead of me for such appointments.

Seriously, I live in a tiny rural state with a centralized health care system and there are just not a lot of doctors for any ailment to go around. Even to see my primary doc and not the nurse prac, I usually have to wait about a month. And while I have nothing against Nurse Pracs, I just find switching providers even within the same practice to be disruptive and I feel really unsafe doing it.

[Eprev20]

hey grant, im a 20 year old male who was diagnosed with ADHD when i was 5 years old.. i had all those symtoms you post/ possibly more. i used to take medication for it, ridalin, Aderall XR, stratera, u name it i took it. I personally found that finding something that interests me after long days work, helps me get ready and focus for the next day.. I dont take meds nemore, stopped when i was 17 cause i felt i was ready to control it. But of coarse there are times where it comes out an i get a little hyper haha. but hey i wish you the best of luck, and if you are looking for something that helps in mediations, talk to ur doctor about Aderall XR (Xtended Release) that really helped me focus on stuff that needed to get done.. down side, u lose ur apatite.

EP