New here | ADHD Information
Hi there chic again!
I have a question for you about how to tell the difference between the productive up times an adhd'r experiences when in hyperfocus, and mania.
During my manic episodes, I am not illogical, and I get things done (sort of). For example, I'll do something like enroll in a class at the gym. On my last manic episode, I decided that I would constantly weightlift until I was the strongest woman in the world! I bought all kinds of weights, and books and videos about how to change my diet....I fantasized about wrestling matches. If someone asked me to fight, I would have said yes, no matter how big and strong the person was.
For 5 days straight, all I did was lift weights. I did not notice any soreness. I hardly ever slept.
Is this at all like a time of hyperfocus in ADHD?
Glen- before I was pregnant, I was taking Zoloft for my bipolar. It did not help me with ADHD! Isn't Strattera basically the same thing as Zoloft??
chic- do you see a big difference with your husband when he is on his meds? Does he become a nut on caffeine? [QUOTE=Miss Frizzle]
Glen- before I was pregnant, I was taking Zoloft for my bipolar. It did not help me with ADHD! Isn't Strattera basically the same thing as Zoloft??
[/QUOTE]
Oh - no - they are totally different meds altogether!
Zoloft is an SSRI - it affects seratonin in the brain and is mostly for depression. They are trying it and other SSRIs on ADHD - with mixed results. It's the last resort really - when the other meds are either judged not right (patient has heart trouble, reacts badly to other meds, addicts) or are worried about the bad press the naysayers here and on other sites are giving.
Strattera is in a class of meds called norepinephrine (read adrenaline) reuptake inhibitors (NRI). It works on a different chemical in the brain - and gets different results. I'm sure you've seen the bad side of strattera here - it doesn't work for everyone and can make you feel dopey and zoned out. Probably there is a subset of ADHD where norepinephrine is the main lacking element - and for them it should work great. The rest of us end up feeling tired, hyperfocused and generally not as good as with ritalin, adderal and the rest of the specific ADHD meds.
That help?
[QUOTE=HeidiMarie]Hi Ellie, welcome! As everyone said, Adderall is bad for ADHD because it can trigger manic episodes. I've heard this before -- but has anyone found out they were bipolar due to adderall triggering one of these episodes? I'm on adderall, and sometimes I get VERY , ornery i guess the word is, and down and don't want to talk to anyone or have anything to do with my son, things that didn't happen before. I wonder if maybe I'm bipolar . . ? [/QUOTE]
Bipolar isn't a cut and dried disorder. There are degrees of the illness - ranging from a borderline bipolar who seems great most of the time - but every now and then will have an "episode" and either become ecstatic and work themselves into a lather or become beligerent or depressed and hide away for days or more.
Then - there's the average bipolar. They go through phases - like a roller coaster. They will be on a "high" - happy ,outgoing and overly productive. They need little sleep and are driven to succeed at everything. Then the coaster sets down the slope. The become quieter, and more introverted and seem more average than before. As the coaster gains momentum down - the bipolar person becomes sad, angry and confrontational. It gets worse each day - until they sometimes become so despondent they end up doing destructive and counterproductive things to themselves and their loved ones.
The extreme bipolar is not a good thing at all. There is NO in between - they rocket from highs where they stay up for days - showing extremes in everything they do - oversex, overeat, clean until their hands are bloody, work until they pass out from lack of sleep. Then the rocket goes straight down - they often beat on themselves physically and emotionally, and their friends and family too. Suicide and murders are a common result for an unmedicated severe bipolar during these times. They can act nearly schizophrenic - not relating to logic and reality and becoming very delusional in their own bipolar world. The extreme bipolar is dangerous to themselves - and others.
So you might be borderline. Amphetamines CAN bring out an episode in a borderline bipolar or manic (they are similar), but it's not very common. Might be hormonal - women are harder to adjust ADHD meds with than men because you have the extra concern of estrogen/testosterone during monthly cycles. That's why a lot of drug companies cringe during the trials of meds when they have to test the women.
Be honest with DR. Find one that deals with ADHD. If you do get differentdrugs, have someone you trust monitor your response to them.
Good luck!
Everybody- Thank you for the words of advice!
You are right! I should not lie to a psychiatrist! I do want to find a different psychiatrist, who is more open to ADHD. I don't think the one I am seeing now is very receptive. I want to get evaluated by someone I trust and respect. If the new psychiatrist thinks that adderall is not for me, I will not go ahead and be my own doc.
chic: What does your husband take for bipolar? I took meds for about 6 years, but I stopped taking them 4 and a half months ago when I found out I was pregnant 
with my first child!!!
I don't want to take any meds until after the baby is born. But I am so scared that when the baby is born and I do not take anything for my adhd symptoms, I will be careless! I am so scared about being careless with this child! The bipolar meds did not help lift my fog! I am more scatterbrained and hyperactive than you can believe!
I am more worried about absentmindedness than ups and downs. I don't wanna leave an infant at the supermarket! I am very serious!
I just scheduled an appointment with a different psychiatrist. The appointment is in a month from now. I will be completely honest with him!
Thank you so much,
Ellie
Hello, Ellie, Welcome to the board. I haven't been on stimulants yet, or any ADHD meds, so far just depression meds. I'm hoping to be tested soon to find out more. Others who are more knoledgeable on the subject of medications will probably let you know more, but I personally don't have experience in the field. good luck and hope you find the answers you're looking for
.For a bipolar person to take stimulants, you are asking for trouble. Stims can throw a bp person into a major mania session. There are others here who can and will explain this better than I can, but please do not try to get on stims by using deceit.thanks barb and repairman! But I want to be less disorganized and scatterred so badly!
I think that I was only diagnosed with bipolar because of a rough time I was going through. I was severely depressed because my early twenties were spent in jail. I was also abusing alcohol and coke at the time of the diagnosis. The doctor put me on Zoloft and risperidone.
It's been years since I've touched any drug/alcohol that was not prescribed to me. These meds have not helped me settle a constant internal feeling of restlessness. I am completely scatterred! When I was abusing coke, I felt much clearer and calmer than I do now. My mania does not settle with the risperadone. The med just makes me feel groggy.
Besides I have never had a complete manic episode. The doctor calls what I get "hypomania".
I wonder if my bipolar symptoms would just go away if I was treated for adhd??
If you don't like the diagnosis, you can't "just change it". But If you feel misdiagnosed, a different doctor may not be bad. there are many problems in medical fields with diagnosis, especially mental health/Psychology, even ordinary medical problems get misdiagnosed sometimes. I would suggest you find a Pdoc that specializes in ADHD and bipolar medicine. P.S. I'm NOT A REAL DOCTOR, I just play one on the internet
.Thank you. My name is Ellie. They say I am comorbid: 1)ADHD
2)Bipolar
I say morbid? Who is morbid. I know you are but what am I.
The problem:
They won't give me adderall because of #2. I wish they would.
That is the problem. Is it very very naughty to go to a different psychiatrist, without telling this new psychiatrist about the Bipolar, so that I could know what Adderall is about?
You guys, on a scale of 1-10, do you think it's a bad idea to not disclose the bipolar to a new med dispenser?
Are any of you on adderall with a dual diagnosis? What's the problem with adderall and mania (I don't get deep depressions)?
More information: I have not been taking bipolar meds for the past few months. There is no interaction danger.
My mind is just so messy. I think that the bipolar was a misdiagnosis. They mistook hyperactivity for Mania? Distraction for depression?
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My family consists of me, a small dog, and a fighting fish. I teach special ed at the moment, and I own exactly 0 television sets. I like to experiment with what I eat.
^
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In case you care.
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Hello to you, and good night!
Welcome Miss Frizzle . . . it took me a while to get the Rx I needed to make
any progress. I suppose it is just so. Stay with it and don't give up and try to
understand that getting excited about not being where you want/wish/need
to be is part and parcel of my problem at least. I want things NOW, LOL. The
rest of the world just does not work my my (our) time schedule. This was for
me one of the great lessons I needed to learn . . . normal folks are not gifted
and are slooooow. So we must wait for them and coach them to complete
their tasks, be it what it may.Hello and welcome!
There is nothing wrong with seeking out a second opinion, but not being honest is not a good idea.
A good doctor is going to listen to your concerns and make his/her own diagnosis. Leaving out anything is only hurting yourself because a psychiatrist needs to know a lot to make a diagnosis. Find a psych that knows a lot about ADD.
And as someone mentioned, a stimulant like Adderall can trigger a major manic episode. It is best that your doctor knows everything so you both know what to expect.
Just to ask, how long were you on the meds for the BP? And what was the reason that you are no longer taking them? Did they only try you on that one med?
(I am diagnosed with ADD, and I have a boyfriend who has BP. There are some similarities, but there are some key differences. And i know it can take a lot of work to get the meds correct. He's going through a med change now, after being on something else for over 5 years. But even my psych has seen me when I'm on an "up" from my ADD and thought I was a bit manic.)
Let me try to answer all your questions...
The difference between mania and hyperfocus... First, there are different levels of mania... I don't know of much that could be confused with a major manic episode. But I'll compare a hyperfocus of mine with his more manic state.
His manic can be full of happiness, or he can be more aggressive/irritating. With the first, he is usually more driven, getting things accomplished...and that adds to his happy feeling... He feels "on" so to speak, and I can relate to that feeling good. I don't know that there is any new single 'obsession' for him that drives it, it's an overall ability to get things done, an increased interest in getting projects completed, and interest in starting new things. He is more likely to look for new hobbies. (When he starts to really organize stuff, that's an early sign of mania starting.) But honestly, it is difficult to tell if he's happy because he's getting stuff done, or if he's getting stuff done because he's "up."
My hyperfocus is driven by an interest in something. I'll get mini-obsessions, and they can consume me at times. I tend to ignore other things for it. A month or so ago, it was puzzles. I was doing 1000 piece puzzles every 2 days. I'd do them before work, at lunch, after work, etc. LoL And I would have rather do the puzzles than eat, sleep, etc.
I'm also a neat freak, in between my ADD messiness, LoL. I will get on cleaning kicks, and I can clean very well, very fast. And I don't stop until I'm done. (I think I also know if I stop, I may not start back.)
I get happy as well, but not when I'm hyperfocused. I'm too focused. I do get excited about my interest, but that's it.
I sometimes get mentally drained from that, but usually it's because I just get bored with it, and nothing else interests me.
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Caffeine...agh, he's been drinking a lot lately, and he's been manic...coincidence? I'd say nope. Caffiene tends to make me tired, it wakes him up. (But caffiene effects various people in different ways.)
I can usually tell if he doesn't take his lithium in the AM.. He gets more "up" and tends to be goofy (and he can have a really mean sense of humor). But he's been med compliant, so I have not seen him off meds... His being med compliant is a requirement for me (and for himself).
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I'm not familiar with bipolar being treated with only Zoloft. Especially if you were not depressed. If you were indeed manic, my understanding is that treatment would be a mood stabilizer, not an antidepressent...?
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As Glen said, there are many types of BP. I had a roommate who was diagnosed at age 29.... He fell into a deep depression, then started cycling hard. With him, he's ok most of the time, but he can start cycling with certain triggers.
My boyfriend is rapid cycling, which can be very difficult to get under control. He is very obviously BP, at least to those close to him.
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It's late, so I'm off to bed. I hope I made sense, LoL, I'm sleepy!
Available evidence suggests that stims are generally safe for bipolars provided they are first stabilized on a mood stabilizer. I would advise against Strattera. It actually has a worse track record of inducing mania that do the stimulants, surprisingly enough.
Taking a stim without a mood stabilizer onboard runs the risk of inducing a manic episode, though the risk is less than with antidepressants or Strattera. Equally important, in clinical studies of bipolars, those not on mood stabilizers did not see improvement of their ADHD symptoms with a stim until they were on a mood stabilizer as well.
Bottom line, a stim is safe and effective for bipolar patients, but it is EXTREMELY important that you have a mood stabilizer on board and at therapeutic levels before you add a stim to the mix. There is a wealth of research available to back this up, and if you'd like more information on the details of those studies, feel free to pm me. I personally take Adderall XR along with Lamictal (mood stabilizer) and Risperdal (antipsychotic) and do quite well on the combination. It is very important to be honest with your doc. If you have reservations about the accuracy of the bipolar diagnosis, please tell him that. He should reevaluate you. If you don't tell him you think it's an erroneous diagnosis, he will likely just go along with it without performing his own diagnostic evaluation. Your doc is your partner in this, and working closely with him will ensure that you get the best available treatments for you.
BTW, the majority of studies on stims in bipolar patients center around the use of adderall or dexedrine in combo with mood stabilizers. There is not as much info available with methylphenidate, though it probably applies to it as well.[QUOTE=Miss Frizzle]
chic: What does your husband take for bipolar? I took meds for about 6
years, but I stopped taking them 4 and a half months ago when I
found out I was pregnant
with
my first child!!!
[/QUOTE]
Congrats on the pregnancy! And I'm glad you decided to be open with the new doctor. (Sorry this is long, I TRIED to stay off tangents!)
He is currently on lithium and depakote, and he takes trazadone at night to sleep. Previous to this, he was on lithium, wellbutrin, xanax, and ambien (or trazadone). (He was also seeing a crappy doctor, in my opinion, LoL. And he's seeing a great one now.) The Xanax was not a good thing, for obvious reasons. And the Wellbutrin was causing issues as well. He was having "mini-cycles" non-stop, several in a day.
The med change isn't complete yet, but we have noticed a HUGE change in his cycles. They are much slower, but he's been more 'up' lately. But he had some bad depression last week (after about 3-4 weeks of 'up'). Since I have known him, he's always been more manic than depressed.
He hasn't had a full blown manic episode since early this year. He stopped drinking at that time, and that's been a HUGE help as well.
He has been diagnosed
for about 8+ years now, but he still hasn't truly accepted that he has BP. He takes his meds, and that's about it. But he is starting to see a psychologist and
he's been taking better care of himself...most of the time, at least.
But with my own experience with him, I know he gets frustrated and wants to not be BP quite often. So I am probably more cautious than some others when writing off a BP for ADD diagnosis.
That being said, the
previous meds he was on were not helping him.
They were keeping him groggy and out of it, and while they did keep the
cycles from peaking, they weren't really doing great in treating his BP...they
kept him sedated.
He is very absent minded still, although not as bad as he
was. It's impossible for me to explain,
but it's a different absent minded than my ADD absent mindedness. But he is more 'forgetful' when he is 'up,'
and when he is 'down' he mainly just doesn't care about anything to remember.
I know with him,
lately he has been much more 'aggressive' although not in a mean way. It's more an irritation...? He definitely goes to his own tune more
often, and at times I feel like I'm living with a ping pong ball that keeps
hitting me in the back of the head, if that makes sense, LoL. He is just 'too much' for me at times. He's also more cocky (for no real reason),
has a higher sex drive, and gets more self-righteous (about things he can't
back up). He'll get worn down at times
in a day, but it is kind of a quick refuel.
When I'm in a hyper focus mode with my ADD, I seem similar. Except mine is more self-confident because I'm getting stuff accomplished, absent-minded because I'm too focused on 1 thing, and I'm still factual/logical with my views.
I read once that a BP person will run into a wall just because it's there, while a ADD person will run into because he/she forgets it is there. I always thought that was pretty accurate. LoL (And when I'm blah, it's because nothing holds my attention, but that changes when I find something to do.)
Have you ever read the Bipolar Survival Handbook? I did when I started dating him, and I learned a LOT. It's well written, too. It goes into BP vs ADD and dual diagnosis, among many other things.
Do you see a psychologist? They can often have some insight as well. (As I mentioned, my psychiatrist thought I had some manic signs, and my psychologist was able to add her insight to that, since she sees me more often and has more interaction with me.)
Someone mentioned Adderall causing people to go manic... Wellbutrin caused me to get very manic-like, as it does for some people, including BP's. (That actually made me think I was BP for a while.) But per my doctor, it's not a way to diagnose. Some people just have a bad reaction, it doesn't mean anything without other signs. Also, I have taken Concerta, Ritalin, and Adderall (not at the same time), and none triggered that same manic feeling I got with the WB.
Anyway, I'm babbling, LoL. So I'll stop there. I hope that helped some. Feel free to PM me, if you'd like.
chicx0r38646.3622106481Oooh Miss F. - can we say "psychotic episode?!?". Wow - why not just pick up the croquet mallet and scream "here's Johnny!".
Amphetamines do nasty things to bipolars. My ex is bipolar and when she took them for dieting (naughty girl - went against me and her doc for that) - she went from controlled rages and tears to outright lashing out, paranoia and physical violence. Same with ephedra, caffeine pills and alcohol.
There's strattera, and a range of other meds. Bipolar sadly rules you out for the good stuff. But - take councilling and get some combination of the non-amphetamines and you can be strolling in here a new Miss Frizzle!!
Wish you lots of luck - if you have anything you'd like to ask or add - pm me I'd love to help if I possibly can!!
Hi Ellie, welcome! As everyone said, Adderall is bad for ADHD because it can trigger manic episodes. I've heard this before -- but has anyone found out they were bipolar due to adderall triggering one of these episodes? I'm on adderall, and sometimes I get VERY , ornery i guess the word is, and down and don't want to talk to anyone or have anything to do with my son, things that didn't happen before. I wonder if maybe I'm bipolar . . ?I seriously wonder if I'm bipolar as well. I have a six year old son who may be bipolar as well. I'm still working on a diagnosis for him. The problem with me is that I don't have insurance coverage for any kind of doctor appointment. So, I'm on Strattera, which I hardly ever remember to take, so I get all kinds of ups and downs and I honestly don't see where it's making any difference in my life. I'm still so very 'stuck' for lack of a better word. Still lose things, am totally disorganized, get extremely overwhelmed with things I don't understand. I can't be bothered to read long things, a lot of crap that my kids bring home from school. All in all, I feel so very incompetent in all areas of my life, so where is the straterra helping? ugh! I'm having such a problem trying to help my pdd-nos, sid, ocd, odd, and possibly bipolar son because I need help myself. And the paranoia! ugh! I'm a mess.
I've been in this loop for several months now and mostly I just do a mass delete of the emails since I'm so easily overwhelmed and my mailbox fills up quickly due to the several other loops I'm in. lol, can't be out of the loop! I'm *so childish!
anyway, just rambling, thanks for reading, if you've gotten this far.
heather
Hi Ellie, I'm in an agreeable mood tonight, so I am going to agree with all of the above.