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At my witts end TRIGGERs
sdta2dgirl70 posted:
Hi all. I am at my witts end at work. I have been in my line of work for almost 16 years now and now that my bipolar has gotten so bad my production has gone down hill. I have gotten permission to work from home. Which is a good thing.. But I am going to be put on a performance plan. I have 3 months to get my performance up to where it is suppsed to be. I am now on so much medicine more than I have ever been on. 3 mood stabilizers. 1 of those is just to help with the weight gain of the other 2. but all three of those are wrecking havoc on my concentration. What am I to do? I just feel like I am loosing my mind. I can't loose my job. I know if I loose it I won't be able to get another and I am not someone who can live off of disability. I just can't do it. My sister is a pharmacist and she suggested a medication that is used for ADHD has anyone heard of a Bipolar person being put on medication for ADHD along with their other medicines? Help Suggestions?
melly2210 responded:
Dr. G can better address the ADHD meds and their significance to a bipolar dx. I'll watch and keep bumping it to the top. He usually answers 1-2 times a day.

As for the concentration issues, maybe you need to learn to manage things differently to account for the cognitive changes. I would definately discuss this with your pdoc and tdoc if you have one.

I suffer from concentration issues big time. Go to the kitchen to cook and forget what I was doing out there to begin with. Etc. Etc Etc. Some days are worse than others. I have found lists to be incredibly helpful. And when I say list, I mean the general goal written down with the smaller goals needed to achieve the greater one below it. And I do check them off as I go.

You are very lucky that your employer is allowing you to telecommute. I'm kind of jealous actually. But in any case, have they put the production demands on you to be done daily or weekly? Is the requirement to be made within a certain hourly time frame? Perhaps negotiating a weekly quota, if that isn't what you have, would be helpful. So if you have a bad day, then you could maybe work harder in another day or so. Being home could present some further distractions like here, the phone, television, cooking, crafts. Whatever it is that you enjoy doing actually.

I wish you luck though. Hugs if you would like them. And keep us posted on how things are going. Succeeding would be a huge inspiration to some of us here.

Hope is that thing with feathers that perches in the soul and sings the tune without the words and never stops... at all. ~Emily Dickinson
Anneinside responded:
I was on Concerta, an ADD drug, because I couldn't concentrate along with my regular bipolar meds. I had to stop it when I started on an MAOI antidepressant. So one answer is, my pdoc did put me on an ADD drug.
melly2210 responded:
bump...Dr G

Hope is that thing with feathers that perches in the soul and sings the tune without the words and never stops... at all. ~Emily Dickinson
Joseph F Goldberg, MD responded:
Dear sdta2girl70,

The usual medicines for ADHD -- stimulants, guanfacine, Strattera, clonidine -- are not generally used in bipolar disorder except occasionally for the treatment of depression (eg, Nuvigil and Provigil both have some research to support their value), or if ADHD is a co-occurring illness in itself.

Sometimes when people have complex symptoms and are wondering whether their medications can be improved on, it can be useful to have a 1-time consultation with a psychopharmacology expert (assuming your own doctor is not addressing your questions about the best medications to your satisfaction). The American Society for Clinical Psychopharmacology has a link on its website to help find psychopharmacologists across the country. (Such consultations can be expensive, and many if not most subspecialists do not accept insurance, but a thoughtful, detailed consultation can often be helpful for clarifying the rationale for all available treatment options.) See: .

- Dr. G.

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