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I don't know what to do at this point..
Jrifenburg posted:
So I'm 18 years old and I have been going to see a psychiatrist for the past couple of months, and in this time I've been prescribed Buproprion (anti-depressant medication). During this time that I have been on it, I've yet to see the kind of change my psychiatrist has told me about such as being more active, actually being able to have a normal conversation, ect..
About a year ago I first read about ADD and ADHD, and (I know the risks) I took ADD medication my friend had gotten from his brother. I felt like nothing I've ever felt before. I was alert attentive, I could focus on homework for long periods of time, I could keep thoughts in my head for more than 5 seconds, I could keep a conversation going, getting involved much deeper in the conversations than I do normally. I'm not sure but I think it was just the feeling of being a normal person. I used to be a straight A student from third grade up til 7th grade. I barely passed 8th grade and had to repeat 9th grade, which was devastating by the way, since the only good friends I hung out with, and still do, were going on without me. The second year of 9th grade up til just yesterday I've been barely getting by.
My psychiatrist and the prescribed pills aren't working one bit and a couple of days ago I went to see him. I had just been denied a job back where I used to live because I failed the drug test. I used to smoke weed a lot. I started to smoke probably around the end of 9th grade. Until recently the only time I smoke is when I go down to hang out with my friends for the weekend. Anyways, when I went to see him, he said, " I can't help you if you keep smoking weed." So obviously he is a terrible psychiatrist, since that isn't even where my problems are stemming from. Plus he makes me feel like an idiot.
I admit I'm depressed, I mean who wouldn't be after going through their senior year of high school with no friends in a different city. I know that depression mimics the symptoms of ADD/ADHD. I just don't think my depression is the main problem, it's ADD. I haven't been depressed since 7th grade, so how is that even an option to consider? What do I do? I feel so helpless, no car, no job, no friends, bad social skills, not even any weed (which wouldn't help but atleast I would be more entertained as I go through countless days alone playing games and watching netflix). The friends I do have back where I used to live don't even like hanging out with me anymore because of how stupid I am. I say dumb things, I can't contribute to conversations, I barely talk, mostly because I have nothing to say since my mind is usually blank, and its not like I'm imagining this I was told by my one true friend, and lately he's been starting to kind of shrug me off.
I want to be able to read, socialize, think, and focus. I don't know what to do. I need advice, because I want to move on with my life. I've honestly been considering leaving and traveling to other countries and try to leave all of this frustration behind but it's my brain, It's not like I can runaway from it. I wish.
GinaPera responded:
Hi Jrifrenberg,

You have my deepest sympathies. It's just not right, is it? For you to have some clear indications that a first-line ADHD medication might work for you and yet this psychiatrists doesn't "get it."

Unfortunately, I'm afraid this situation is more common than the reverse: Psychiatrists who understand the treatment protocol for ADHD.

For one thing, Wellbutrin/Buproprion is not a first-line medication for ADHD. It does help some people with ADHD and for others it makes symptoms such as anxiety worse. It just depends on the individual.

Some psychiatrists mistakenly assume that Wellbutrin is great for their patients with ADHD because it hits several targets that usually require two or more medications. For example, some people with ADHD do well on a stimulant and an antidepressant (simply put, targeting dopamine and serotonin). In this way, some psychiatrists see Wellbutrin as a "twofer."

The other perceived advantage is that it's not a schedule II controlled substance, as are the stimulants. So it requires less paperwork on the physician's part (also a special license).

You would serve your interests best by learning about a methodical medication protocol for treating ADHD and sharing it with your physician (if that's the one you're stuck with). I offer one in my book because I felt it was important for patients to learn how to be more pro-active, given that so many psychiatrists just don't do well in treating ADHD.

I would encourage you to keep advocating for yourself. You sound smart and knowledgeable about what you need and where you'd like to be. Yes, the marijuana usage is a bad idea; it can further exacerbate low initiation, working-memory deficits, etc. So you need to stop. The problem with some psychiatrists is they take a black-white stance on this, instead of seeing the marijuana usage as a possible symptom of untreated ADHD (using it to deal with the anxiety). And using that information to provide better treatment.

It's completely unfair that people with ADHD have to work so hard to get the care they deserve. I wish it were different. But that's the reality. Be pro-active. Be persevering. And know that you are well within your rights in doing so.

Good luck!
Gina Pera

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