Posted by viridis on November 15, 2002, at 2:58:53
In reply to Re: ADD Med advice and LINK. » Alan, posted by kelranji on November 14, 2002, at 23:33:49
Hi Kelranji,
I agree completely with Alan. Many doctors don't seem to have a clue about how to treat mental problems like serious anxiety, depression, or ADD, and blindly prescribe antidepressants (especially SSRIs) for just about anything. I spent years on the antidepressant merry-go-round, never getting better and experiencing severe side effects that several doctors (including both GPs and psychiatrists) either dismissed as "imaginary", "exaggerated", etc. or simply said were unavoidable aspects of the treatment. Antidepressants can be great for some people, but others react very badly.
The only real relief I got was with Xanax, which my former GP would occasionally prescribe very short-term for insomnia. Of course, he (and my current GP) refuse to prescribe Xanax or other benzodiazepines long-term, because they claim they're "addictive".This misguided view has been discussed by Alan, Hiba, me, and many others at great length recently on this board. Not to sound like a broken record, but addiction involves continued use and/or escalation of use of a substance, despite its causing harm to the user. If benzos (or stimulants in the case of ADD) effectively treat the condition and you aren't abusing them (e.g., using them recreationally), then you're not addicted, any more than a diabetic is "addicted" to insulin.
Benzos can cause medical dependency, which means that discontinuation may be difficult, and may require a gradual decrease in the dose over time. This also occurs with antidepressants (especially SSRIs), and recent evidence suggests that it may be more common and severe for SSRIs and related drugs than for benzos. However, when this occurs with antidepressants, drug companies and many doctors like to use the more innocuous-sounding term "discontinuation syndrome", reserving the (mis)use of the term "addiction" for benzos and stimulants (which, perhaps not coincidentally, are off-patent and so are available as inexpensive generics).
Really, your best chance of getting well is to find a doctor (ideally, a psychiatrist) who doesn't have these biases and listens to what his or her patients say. I finally found a psychiatrist with these characteristics -- just by luck. He immediately diagnosed me with a serious anxiety disorder and prescribed Klonopin and Xanax (both benzos). This had a tremendous stabilizing effect, and as I've discussed here many times before, I still use the Klonopin daily at the same low dose that I started with. After over a year it provides the same benefits at 1 mg/day, with no side effects. He cautiously experimented with low-dose SSRIs, and quickly concluded that these were not appropriate drugs for me, even with benzos (after several other doctors had insisted that antidepressants alone were the solution to everything). I suspected for years that I had ADD, and had been diagnosed as such by two therapists previously. He picked up on this too, and prescribed Adderall. It's had a great calming/focusing effect and, like the Klonopin, still works well at a very low dose after nearly a year. He was very careful in prescribing these meds and monitors my use closely, but he and I agree that the improvement has been tremendous, and justifies long-term use of Klonopin, Adderall, and occasional Xanax (lifetime if necessary).
Your condition, reactions to antidepressants, and experiences with doctors sound very much like mine. It's incredibly frustrating, but you just have to find a competent doctor -- this makes all the difference. Again, you're most likely (in my opinion) to be successful with a psychiatrist, but even then, you may have to see several to find one who really understands your situation and isn't afraid to prescribe the appropriate meds.
By the way, I have managed to hold down a pretty successful career as a researcher, but until I got stabilized less than two years ago, it was an incredible struggle. I nearly gave up many times. I lost large parts of every year to severe depression, was anxious the majority of the time with frequent clusters of panic attacks, often couldn't sleep for days at a time, and sometimes couldn't even leave the house. In addition, organization was a huge problem, and the mess/chaos that resulted from ADD just heightened the anxiety and resulting depression. Somehow, I managed to get through and achieve quite a bit in the few months of each year during which I felt motivated and somewhat stable, but life was exhausting. Things aren't perfect now, but at least I can deal with stress fairly rationally, am generally enthusiastic about what I'm doing, and most of all, I don't have to worry constantly about when the next set of panic attacks, major depressive episode, etc. will hit.
With the right doctor, you can get better, and I wish you the best of luck in finding that doctor as soon as possible.
poster:viridis
thread:127542
URL: http://www.dr-bob.org/babble/20021108/msgs/127722.html