Oh geez, this turned out to be long.



Do you have a talking therapist in addition to a doctor? I have two. The doctor will only care about clinical symptoms. Well, actually the first doctor who diagnozed me was very very good. Btw, the hypersensitivity is a major symptom of untreated lifetime ADD. (ADHD/ADD is more prevalent in boys, but that may be because it goes undiagnozed in girls, it tends to be more ADD than ADHD, so they have fewer behavioral problems, but they do have a score of all the other "fun" things. Sensitivity to criticism and mood volatility being up there.)

Therapists also vary wildly in quality. My very first one, from the Student Center at school (there through the Mental Health Training institute, so she didn't even have all the certifications yet), was very good, and so my lifetime impression of therapy is that it can be a life-changing, powerful thing. When I went to see Natasha, I kept failing classes. Every semester, I wouldn't finish the final papers for my humanities classes (it would stay in the 3rd draft stage, and I just couldn't bring myself to hand it in). I would make up the grade afterwards, but I wasn't catching up. It was my last semester at work, and I've gotten an academic expulsion note (you aren't allowed to fail classes on a full-ride scholarship), and I was so scared. I saw the same cycle happening again: starting the semester strong and confident, crumbling towards the end, failing again, being kicked out of college. I was desperate.

Long story short, by the end of the semester I'd made up all my papers & projects (except for one), gotten all A's & B's, and my paper won the department award. I'd gained enough confidence in myself to move to the other coast with nothing but 2 bags of luggage and a few months' rent.

Then there were a few bumps, I was lonely and missed home, and started looking for help again. One therapist I interviewed (they should all provide the first free session) was so bad, I left his office in anger, and cried on the way home. Once home, I called him and yelled at him. (And I'll never go to a man again.) The 3rd one wasn't very good either. She was smart & logical, but I got a sense that she didn't like me, that she was a tad condescending and judgemental towards me. Still, she made me angry in a positive way, and I found Lisa through a newspaper ad. She was also looking for patients to fill her training hours (not yet certified), probably the best I've encountered so far.

Natasha (#1) was very warm and supporting. Just like you said, when she told me I wasn't a bad person, I believed her (although I argued first). I need to remember to carry that kind of unconditional acceptance always inside of me. I cried in her office a lot, but would emerge feeling purged, cleansed. Lisa (#4) was more analytical. We discussed issues which I thought had already been talked over and settled, and gotten new insights. Every once in a while she'd give me pieces of psychoanalytical theory that helped me understand & deal with myself in a completely non-judgemental way. I stopped seeing her after a year because I was done. Perfectly happy and at peace.

Then I moved back, things happened, there were bumps in the road, and I was depressed. (Sidenote: change is bad. Routine, stable, familiar environment is good, even if it will feel boring.) I was in pain, and I had the kind of attacks you describe. The therapist #5 at the Training Institute wasn't very good, just in terms of intellectual capacity, she couldn't keep up with me. The next one I saw was a doctor (#2) at a local mental hospital to fill my prescription. That was very frustrating, stressful, and upsetting, because she treated me with suspicion, and I know it's because she worked for a public hospital, and not in private practice.

Here's the thing with ADHD - the meds are frequently abused, since they are essentially speed. You'll frequently see headline of students buying Adderall to pull all-nighters and get high. The other day, three suits in front of me in the line at Starbucks were talking about how you're supposed to crush and snort Adderall. There's various restrictions on how often you can fill your prescription. Doctors are used to being suspicious when it comes to ADHD & requests for meds, more so in a public setting. (I encountered none of this in the private practice, paid for by insurance. It was shocking and unpleasant to have my word doubted.)

That is why your doctors will not suggest that you may have ADHD. I am a proselytizer for it, because the meds transformed my life. There's lots of info online about adult ADD, here's one sample link.

http://health.msn.com/health-topics/adhd/articlepage.aspx?cp-documentid=100104777

Also check out addforums.com. There's sub-forums for co-morbid conditions including depression, bi-polar, and lots of discussions about meds, social experiences, etc.

However, ADHD is mostly self-diagnozing (that's what my doctor #1 told me). You'll react to the drugs differently based on whether you have it or not. If you don't, you might get high, but also anxious & agitated, unpleasantly so. If you do, they'll actually calm you down and make you focus.

There's lots of drugs, but the best-known and best one is Adderall XR (extended release), and make sure that it's the brand, not the generic.

Do you have a choice of doctors through your insurance? I would suggest going to a NEW psychiatrist (after you do your research online about adult ADD symptoms and checklists), and say that you might have it. Tell her of the difficulties you've had in your academic life - very smart and ambitious on one hand, but stuck in inactivity and self-criticism on the other hand. Don't mention depression. Don't mention bi-polar. Stimulants are contra-indicated for bi-polar since they can exacerbate manic episodes. Honestly, you don't have bi-polar. And Adderall is a very powerful anti-depressant. It stimulates production of dopamine, norepinephrine, and serotonin.

From wikipedia:
---
Adderall has also been used successfully to manage severe cases of treatment-resistant depression. Individuals who show little or no response to typical antidepressants, including SSRIs and tricyclic antidepressants, are more likely to respond to psychostimulant therapy. These patients, however, are the exception rather than the norm among those with depression and this is not an FDA-approved indication. Other recognized uses include the treatment of:

Idiopathic Central Nervous System Hypersomnia established by recognized diagnostic criteria
Drug-induced brain dysfunction
Epilepsy
Narcolepsy
Senile apathetic behavior
Psychiatric differential diagnosis of depression
Obesity
----

You mentioned that you are taking other meds. You should find out (Internet research, addforums) whether 1) it would react with Adderall, 2) how quickly it flushes out of your system if you need to stop taking it, 3) if you can stop taking it safely. If it's Lexapro, I've read that works well with Adderall. However, it's best if you don't mention your existing meds to the new doctor, because that will probably screw up your chance of a proper diagnosis. They'll ask who's your current doctor, oh so you have depression and mood disorder, let's treat you for that, and you know how well that's been working out for you (not well).

You are the stewart and guardian of your body. Medicine freely admits it doesn't know how or why the psychiatric drugs work. It's up to you to dose cautiously and then carefully watch the effects on your mind or body. If it's not good, then it's not good for you! Only you can know what works for you. Try something new.



Wasn't that a good book? I especially liked how it wasn't depressing, althought it was dark in part and moody, because she focused on her manic episodes. I've had some hypomania, and it was very cool to read her descriptions.



I had these what I called "attacks" when I was depressed. I would lose control over my emotions and they spiral wildly, and my body would get all hot and stiff, and I felt I couldn't control it either. (Had these all my life until the last few years, but when I was depressed, it was bad - crying fits for hours, and serious plans of self-damage.)



We've agreed that we don't like your current doctor. Try my approach. It's very important to have TWO people: a psychiatrist to prescribe you meds, to whom you tell only what they need to know (so that you are the one in control of what you put into your body), and a therapist - a safe place to vent all your fears (except for current thoughts of suicide, as she may feel compelled to take action to prevent it; unless you are serious about it, in which case do tell and do whatever it takes to keep yourself alive. Otherwise, you can describe past thoughts of suicide, but make sure to explain why you don't feel that way anymore; you don't want a misunderstanding.)

I also recommend finding a woman. That's my bias.



I've mentioned, the forums have lots of people who use Lexapro with ADD meds and like it. What triggers the crisis moments? Also, now I'm going to be a drug-pusher, and suggest talking to your friend again about ADD. Ask her what it's like and how the meds work for her. She might offer you to try a pill. (My doctor #1 told me that's often how people diagnoze themselves, they try a friend's medicine.) I don't know what she uses; Adderall however works immediately and flushes out of your system within a day with no lasting effects. But don't be discouraged if it doesn't work, it's different for everyone. I tried Ritalin and it was awful; I felt so zoned out and lazy, I couldn't even focus enough to read, and I can always read. Nasty thing.