attention deficit disorder

Thanks to everyone who has contributed to or read my "sick role" thread. Especial thanks to those who have taken the time to send support/advice in managing my time. I am inspired. Not to the point of actually doing it today but will remember it again tomorrow.

If you have read that thread, you will know I think I may have attention deficit disorder, masked in the last few years by the sleepiness of OSA. The more I read about it in adults, especially in women, the more I think I fit the picture. Females typically show dreaminess/hypoactivity rather than hyperactivity.

I know a few others here have mentioned they have AD/HD. I would be very interested in hearing about your experience of the disorder.

For instance, I was really battling at work this morning. I was concentrating really hard, but even so I needed help to sort something out I should have been able to manage myself. And reading things was really difficult, the letters seem to jump around. Then about midday before lunch the "fog" seemed to lift, and I felt normal again. Does that sound like ADD? I am a little short of sleep (owed about 5 hours over the last 3 nights) at the moment, but not physically exhausted. Could it just be sleep deprivation that makes me so scattered?


I had an "off the record" word with my manager, who is very supportive. I told him I spent my day off sitting in my messy house researching ADD, which is very ironic! I am lucky that it is safe for me to be honest at work about my mental "brightness', there is support at hand. If not, I think I would have to leave work for fear of getting out of my depth on a bad day. I love my job.

I am seeing my GP (PCP) on Monday, will raise it with her then. As I'm also being treated for depression, I doubt whether any ADD medication can help. Wouldn't it be wonderful to pop a pill just to feel "normal" again.

Di

I was one of the original ritalin kids (started on it back in 1971 or so) and
look a bird!

Moby,

I was an ADHD kid (never had all 3 wheels of the tricyclke on the ground at the same time, impulsive, tested off the scale on standardized tests, but "chronic underachiever, etc.). Conventional wisdom at the time is that a persom "outgrew it".

In my late 30's, I started looking into this again. After winding through my company's "Employee Assistance Program", I ended up at a psychiatrists office being evaluated for adult ADHD. My doc is a great guy, very conservative, told me at my first visit that he didn't believe in ADHD as a primary diagnosis for the most part. After some charmed discussions where I was evaluated for everything ese, I was assigned what the psychiatric community referes to as an axis code (seems to be the equivalent of a giagnosis code) of 314.00 - attention deficit without hyperactivity - what you described as dreamy/hypoactivity. I've been on some sort of meds for 15 years now - tried most combinations - both on and off label (with my physician leading out on it of course).

I've been active locally with some ADD/ADHD support groups, read voraciously on the subject, was very active in my own treatment with a very fine physician. The meds can help, and everyone's mileage certainly does vary. Almost everyone I've met that possibly has ADD and is successfully managing it has found that committed lifestyle adjustments help sa much as anything. The meds help, but aren't a silver bullet by any means. They do nothing at all if lifestyle changes aren't made.

I had a sleep study done 2 months ago and found out I do indeed have sleep apnea - rated "severe" not that it matters - or that there is universal agreement on what severe means. I began the CPAP treatment: 1) So I could breathe at night and didn't stress my heart any more, and 2) So I could hopefully shake the late morning/early afternoon fog that even stimulants couldn't cut through some times.

My med management doc was very surprised at my apnea. I don't fit the (fair/unfair, accurate/unfair stereotyped) profile of someone with apnea - I'm slim, I run several times a week, don't snore, none of my meds seem to lead to apnea. In fact my med management doc was skeptical until he saw my sleep study. He's now backing me off the ADD meds - which has been an interesting experience. I always wondered how I could take a Ritalin/Provigil "cocktail and be sleepy to the point of fighting to stay awake.

All that said, I think I still have ADD symptoms that I carried into adulthood (you don't, as I'm sure you have found out suddenly develop ADD as an adult). I think the apnea was magnifying the symptons WAYYY out of proportion.

Let me know how this plays out. I'm very interested in any relationship that may exist between ADD and sleep depreivation. By the way, ADD usually brings with it as many plusses as it does minuses - find them in your own case and leverage them.

I wish you well. If you'd like to discuss further, PM me.

I have ADD and was diagnosed as an adult..I was the girl who daydreamed during class, who could make a list and lose the damn thing..I was on meds from the age of 29-35 and had to get off of them because the side effects outweighed the benefits..

Now I am doing sort-of ok, but non-medicated..any stimulant puts me to sleep

Sis S,

I've heard they miss the ADD things in girls as they're growing up - mostly for the reason you describe. The dreamy types generally aren't disruptive and schools seem to value compliance as much as anything else. Unfortunately, they can just make it through the school year 'blinked out' for periods of time. I spent a year of college like that when the H disappeared out of ADHD.

I know exactly what you mean about losing things - particularly lists and reminders. Well meaning people always told me to write things down - which I would do, but I'd either lose the paper or forget to look at the damn thing. Now if I need to remember something, it get's written on the back of my hand - which works well until I wash my hands. Maybe a sharpie?

I still lose things more often than I'd like to - umbrellas are impossible for me to keep track of. Sometimes I wonder where all the umbrellas I've owned in my life have wandered off to. I suspect they've found a nice quiet place in the mountains somewhere, formed an autonomous collective, and are now leading the umrella equivalent of the good life.

Out of curiosity, has treating the apnea helped the ADD at all?

Robbie wrote:Sis S,

I've heard they miss the ADD things in girls as they're growing up - mostly for the reason you describe. The dreamy types generally aren't disruptive and schools seem to value compliance as much as anything else. Unfortunately, they can just make it through the school year 'blinked out' for periods of time. I spent a year of college like that when the H disappeared out of ADHD.

I know exactly what you mean about losing things - particularly lists and reminders. Well meaning people always told me to write things down - which I would do, but I'd either lose the paper or forget to look at the damn thing. Now if I need to remember something, it get's written on the back of my hand - which works well until I wash my hands. Maybe a sharpie?

I still lose things more often than I'd like to - umbrellas are impossible for me to keep track of. Sometimes I wonder where all the umbrellas I've owned in my life have wandered off to. I suspect they've found a nice quiet place in the mountains somewhere, formed an autonomous collective, and are now leading the umrella equivalent of the good life.

Out of curiosity, has treating the apnea helped the ADD at all?

Since starting CPAP my ADD is less problematic as it once was..I can remember where I put my lists and remember to look at them

I am no longer acting like a ditzy blonde, although I do when I need to, for instance if someone were to talk about math, my mind goes blank and I have a lost look on my face.

BTW, I found a red and white umbrella the other day, was it yours?

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Reading more about ADD, and more things are falling into place. For instance, it's the only thing that interests me at the moment!!!!

One of the things that I think affects me most is the difficulty changing activities or "transitions". I find it hard to change from doing one thing to doing another. Just knowing that has helped me address it "Oh, this feels hard because it is an activity change, I have to change activities now". Then I hold onto that thought instead of drifting off into other interesting thoughts and staying exactly where I am.

I have set up a little system of post- its which I transfer from the "to do" sheet to the "done" sheet. I have had so many systems in the past, but all were a tad more complicated. I really enjoy setting the systems up! This one is so simple, there wasn't really any fun setting it up, just buying the post-its and (indulgences) a "special pen" and a bright yellow file which I hope I don't lose. The aim is to remind me to change activities, not to remind me what needs to be done. I know what needs to be done, the problem is "getting round to it".

I think this ties in with the sleep apnoea/sick role problem because "getting up" used to consist of grabbing my pillow and a quilt and decamping to the couch and the TV where the rest of the day passed very quickly.

At work I think I cope better because time there is very structured, and there are lots of prompts and cues and people demanding stuff of me. Also, having people around doing the same sort of thing acts as a prompt too. Funny that my main interest has always been neuro rehabilitation where I actually have to *do* a lot of prompting.

Di

Robbie wrote:I still lose things more often than I'd like to - umbrellas are impossible for me to keep track of. Sometimes I wonder where all the umbrellas I've owned in my life have wandered off to. I suspect they've found a nice quiet place in the mountains somewhere, formed an autonomous collective, and are now leading the umbrella equivalent of the good life.

Ah, the disappearing umbrella thing.

I never thought that would come up on CPAP.com.

I was just telling my wife the other day that my umbrellas keep disappearing. Every time we have a good downpour, I have to go out and buy a new one.

And all the free ones I got from work (we used them as giveaways) have also disappeared.

I keep trying to blame my daughters, but they all say they don't have a clue where I leave them.

So, it's time to go buy a new one. Now, if I could just find my keys.

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I also have adult ADD and never realized it til the doctor diagnonsed my eight year old son with it and it does run in the family so I went to my doctor and sure enough I had it too. I remember back as far when I was in grade school and I had a very hard time organizing my thoughts and losing things.Even today I have a difficult time manageing my time and being very forgetful. With the treatment for sleep apnea and some meds I am getting on track and performing alot better at work and in my personal life as well.

For the longest I thought it was depression but it was the ADD that made me feel depressed. My son is doing alot better in school and he does not act out like he used to. Its amazing what the right meds can do, don't get me wrong I realize medication is not always the answer but when all else fails you don't have much of a choice.

Moby wrote:Thanks to everyone who has contributed to or read my "sick role" thread. Especial thanks to those who have taken the time to send support/advice in managing my time. I am inspired. Not to the point of actually doing it today but will remember it again tomorrow.

If you have read that thread, you will know I think I may have attention deficit disorder, masked in the last few years by the sleepiness of OSA. The more I read about it in adults, especially in women, the more I think I fit the picture. Females typically show dreaminess/hypoactivity rather than hyperactivity.

I know a few others here have mentioned they have AD/HD. I would be very interested in hearing about your experience of the disorder.

For instance, I was really battling at work this morning. I was concentrating really hard, but even so I needed help to sort something out I should have been able to manage myself. And reading things was really difficult, the letters seem to jump around. Then about midday before lunch the "fog" seemed to lift, and I felt normal again. Does that sound like ADD? I am a little short of sleep (owed about 5 hours over the last 3 nights) at the moment, but not physically exhausted. Could it just be sleep deprivation that makes me so scattered?


I had an "off the record" word with my manager, who is very supportive. I told him I spent my day off sitting in my messy house researching ADD, which is very ironic! I am lucky that it is safe for me to be honest at work about my mental "brightness', there is support at hand. If not, I think I would have to leave work for fear of getting out of my depth on a bad day. I love my job.

I am seeing my GP (PCP) on Monday, will raise it with her then. As I'm also being treated for depression, I doubt whether any ADD medication can help. Wouldn't it be wonderful to pop a pill just to feel "normal" again.

Di

I don't think I have classic add but I do have trouble switching to different activities. I tend to be so engrossed in what I'm doing any distraction irritates me. I really have to work on that.

My son is 4 and has been exhibiting symptoms associated with add. He has trouble with transitions and also has trouble staying focused on one thing. He just flutters from one toy to another and prefers to be entertained by an adult, another child or especially tv. He whines that he is bored a lot.

I discovered a few months ago that he has apnea too and he had a tonsilectomy 3 weeks ago. His sleep is still poor, but I have seen him get involved in some little projects more in the last week or so that last more than a few minutes. It makes my heart sing when he gets engrossed in a project because it happens so rarely. I am hoping that as his sleep improves over the next months that we see his ability to concentrate improve as well. I have read that ADD may be related to sleep disorders in children. It seems like a life long issue with sleep could set a person up for some difficult-to-cope-with brain mechanisms.

I hope cpap helps you with this issue. And, have you considered that your anti-depressant could be contributing to the problem? Some antidepressants calm and soothe and some are more energizing. I always found that antidepressants helped me focus and transition better but I have been off of them completely for several months and am finding I have to work harder at those skills now. Other people I have heard react differently.

I also appreciated the sick-role thread you started. I didn't post there, but I completely understand. I am a very goal oriented person and when I was sick all the time before diagnosis it was so depressing to not accomplish anything for days at a time because I was too tired or in too much pain. I'm happy to give up that role now. Of course everyone just thought I was a hypochondriac (except probably my husband) so they never stopped expecting me to do all the stuff they thought I should be doing. It was a frustrating string of years.

WHat thought-provoking threads! Thanks!

Jen

New research on the connection between ADHD/ADD and sleep apnea.

http://paktribune.com/news/index.shtml?192933

Researchers found the majority of a small sample of people suffering from obstructive sleep apnea or other sleep problems also had a high degree of attention-deficit problems, as well as neuromuscular and psychiatric conditions. The results were to be reported on Oct. 25 at the American College of Chest Physicians meeting in Seattle.

Thanks for the link Rosemary.

It is interesting that the cpap treatment reduced the no of people with ADD symptoms from 55% to 18%.

More than half (55 percent) of the participants showed significant attention impairment at the beginning of the study, but improved substantially after receiving continuous positive airway pressure (CPAP) treatment. CPAP requires the individual to wear a facial mask that creates enough pressure to keep the airway open


Another 18 percent of the participants, however, continued to have serious attention-deficit problems even after treatment. These individuals were diagnosed with adult attention-deficit disorder and required medication and skills training.

.

As for those 18%,I don't think there is an accepted medical estimate of the percentage of the general population affected with ADD. (Also there also appears to be some argument as to the diagnosis of AD). But a guestimate of affected adults is quoted in the literature I've seen as 10-20%, which would bring cases intractable to cpap down to the guestimated average.

My symptoms are much much worse at the moment. Or maybe I am just noticing them now I am aware of them. I am controlling my work environment a lot more, so I don't let people get me to do lots of things at once (colleagues are the worst culprits, most of them are ADD too I reckon. I make them wait now). I am also noticing other people, who I used to think of as "rude" are in the same boat...interrupting, not hearing, forgetting what they are doing in the middle of doing it...

I controlled myself at home all day yesterday, and managed to be very productive with my post-it notes and frequent breaks. But when I met my friends (human and canine) in the park in the evening, BOY! did I let go!!! And I never suspected myself of being hyper!!! Letting off steam, did that whistle BLOWwwwwwwwwww!!!!! And exercise class - suddenly there seems a real point to throwing all those punches!




Di

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Jen,

It would be so good to be a goal oriented person.

I can imagine how frustrating OSA was for you.

Re the meds, I have an appt with a psych. in a couple of weeks, (have to get the Gp referral first, mine is off sick. I have it all ready for her to sign )

I'm on Effexor for the depression, which has been very effective. But it is difficult to come off. It is used to treat ADD, but I don't want to increase the dose because of the difficulty of coming off it and also the side effects of hypertension in my case and also increased appetite (only for food unfortunately, the libido can be affected as well!)

I spoke to a local support group yesterday, she recommended a psych appt to get an assessment and a proper diagnosis. presumably she knows what she's talking about, I'm not even sure what questions to ask at the moment, also there's a nagging doubt that the current fashion is to "medicalise" personality. Some of us just are untidy and inattentive, maybe, it's not necessarily a psychiatric condition.


Anyway, thanks for your interest and your input.

I mean everyone, thanks for your interest and input.

Moby wrote:
I spoke to a local support group yesterday, she recommended a psych appt to get an assessment and a proper diagnosis. presumably she knows what she's talking about, I'm not even sure what questions to ask at the moment, also there's a nagging doubt that the current fashion is to "medicalise" personality. Some of us just are untidy and inattentive, maybe, it's not necessarily a psychiatric condition.

Someone else who has this view is Thom Hartmann. He sees ADHD/ADD as a variant in personality that doesn't happen to fit well with the society we have evolved to with the advent of farming. He says there are hunters (ADHD) and farmers (non ADHD). The hunters don't do so well in a farming type society. He's written some books in this vein. I don't have time for a search for them right now.

Then there's Daniel Amen, who has done a bunch of brainscans of people with ADHD. He looks at different subtypes of ADHD, and his view is that some of what gets labeled bipolar and other types of psychological disorders are often types of ADHD. His books are interesting in that he looks at different treatments for each type. He looks at the traditional meds and also includes supplements. He says that not all ADHD treatment is right for everyone.

I thought I had ADHD (inattentive type) and was diagnosed with it, but now pretty sure that it was OSA. The medications for it all just interferred with my sleep and made things worse and kind of weird. It's now much easier for me to stay on task. I can also multitask better. However, learning the skills of organization is something I need to do next. But some days I'm sharper than others.

Moby wrote:Jen,

It would be so good to be a goal oriented person.

I can imagine how frustrating OSA was for you.

Re the meds, I have an appt with a psych. in a couple of weeks, (have to get the Gp referral first, mine is off sick. I have it all ready for her to sign )

I'm on Effexor for the depression, which has been very effective. But it is difficult to come off. It is used to treat ADD, but I don't want to increase the dose because of the difficulty of coming off it and also the side effects of hypertension in my case and also increased appetite (only for food unfortunately, the libido can be affected as well!)

I spoke to a local support group yesterday, she recommended a psych appt to get an assessment and a proper diagnosis. presumably she knows what she's talking about, I'm not even sure what questions to ask at the moment, also there's a nagging doubt that the current fashion is to "medicalise" personality. Some of us just are untidy and inattentive, maybe, it's not necessarily a psychiatric condition.


Anyway, thanks for your interest and your input.

I mean everyone, thanks for your interest and input.

Moby,

If I remember correctly Effexor is very closely related to Lexapro. Effexor contains two versions of the same chemical--mirror images of each other or isomers. Lexapro only has one of them, thought to be the more effective of the two chemicals.

What I am trying to say is I know a LOT about weaning from Lexapro. Lexapro has a short half life in the body--meaning it leaves the body super fast--and leaving your neurons in a complete panic. They freak out without the drug and you feel like crap--I had dizzy spells, intense rage, intense irritibility, and something I can only call "brain zaps"--imagine my joy at finding out that other people had experienced this too and I wasn't crazy!

The real key for me was serious research. I tried various methods of weaning very slowly. It never worked. By the time I got to a quarter dose every other day I was "jonesing" for lack of better terminology and like so many other poor saps hooked on these drugs, ended up back on the Lex several times. I was desperate to get off of it and spent hours trying to find a solution.

This is what I found out that worked. Lexapro (And Celexa and Effexor I believe--but you will need to check yourself to be sure I am correct, OK?) have a very short half life. If you wean off of it partially and then replace it with another SSRI, like Prozac, that is easy to wean from because of its long half life, you will likely have more success. The prozac has such a long half life that your body is able to start doing its job of making serotonin on its own without freaking out and all the side effects. My "discontinuation symptoms" of prozac (the technical term) were so mild as to be virtually unnoticeable.

My psych had never heard of this idea, but after my failures and feelings of desperation to get off, he was willing to let me try this technique. I got it from reading a journal article on pubmed.

I hope that helps you Moby. I know how it feels to be doomed to paying a drug company each month for a drug you really don't want to take any more.

But, if you don't really want to go off of it, disregard my advice. I just jump at the chance to help someone with this problem because I had it so long. I gave this advice to another cpap'r here who talked it over with her doc and her doc agreed that it sounded like a good plan and she is going thru the process now of weaning. Her doc started her on the prozac right away and didn't make her wean first, so it will be interesting to see how that goes for her.

Jen