"Treat the disease, you win some, you lose some. Treat the patient, you always win."
~Patch Adams~

Sunday, December 9, 2012

ADHD and Bioidentical Hormones!

Hi everyone, hope you are enjoying a good second half of your weekend.  Here in NC, it's in the mid 60's temperature wise, so when I finish this post I am heading out the door for a fitness walk with my Nordic walking poles. 

I've gotten several inquires via Facebook and my email about how bioidentical hormones affects ADD/ADHD.  It's a topic I am quite familiar with, as I was formally diagnosed with ADD when I was in my late 30's.  I already knew I had it; I have two Master's Degrees in education, and through the psychology courses I had taken knew I had many of the classic symptoms.  Ritalin use was at that time just becoming widespread, and it was thought that children outgrew the symptoms as they matured.  We know now that although an adult may (or may not) be better at coping with the symptoms of ADD, it is not something you simply outgrow.  At least I had some insight into some of my childhood difficulties; I was a huge daydreamer, very easily distracted and hugely disorganized, but I attributed it to an exacting, verbally abusive father who had me living on pins and needles at all times.  My mom used to send me upstairs to get something for her, and more than half the time I used to come back downstairs and ask what it was she wanted me to get.  I'm very intelligent but was only a mediocre student until I got to high school courses I was interested in, and I excelled in graduate school.  I was very disorganized, and a first class procrastinator. 

In my education courses, we learned quite a bit about helping students cope with ADD issues, and I was able to put many of those coping skills to use in my own life.  For those of you who are wondering what some of the signs/symptoms of ADD/ADHD include, here is a list from WebMD.  Numbers 1, 4, 5, 6, 7, 9, and 10 used to describe me to a "T".  I never married, so #3 was never tested, and #8 does not apply to me at all.  I am chronically early because I am such a people pleaser. 

I resisted taking medication (Ritalin was the drug of choice when I was in my 20's) for the condition, partly because I had a doctor who didn't believe in ADD and thought it was a bogus diagnosis. I struggled, but worked hard to compensate for the problems the ADD caused, and I was for the most part able to manage the symptoms.  Remember, this is back before Internet, smart phones to send reminders, etc-----I relied on a lot of lists, almost to the point of absurdity.   When I was 33, I was in a horrific car accident that has been detailed elsewhere here on the blog.  Between the medications, anesthesia, surgeries (I ultimately had 15 orthopedic surgeries to get put back together), stress (I became medically permanently disabled and so lost my teaching career) my coping skills went out the window. I was also deeply depressed and the medications I was taking for that were adding to my lack of ability to cope with much of anything.  Here is a very partial list of side effects for antidepressants,  the restlessness, anxiety and headaches just added to the ADD issues.

I was in therapy with a psychologist by the mid 90's and he was the one that diagnosed my ADD officially. Much more was known about the condition by then, and I was so desperate that I agreed to go on Ritalin.  It did help a little; I felt like I was able to concentrate a little more, and I made a herculean effort to get more organized in every aspect of my life.  Once Concerta became available (the long acting time release form of Ritalin) I went on that, as the Ritalin for me was only effective for about two hours at a time, then I could feel its effects wear off.  The Concerta caused my already poor sleep to become very poor sleep, the medication seemed to stay in my body longer than it did for most people.  By 2002 I had a partial hysterectomy, which accelerated my peri/menopause changes.  Add the brain fog, distractibility and lack of sleep (all common peri/menopausal symptoms) to an already addled ADD brain, and it's a very special kind of hell.  My whole life consisted of just trying to get out of my own way, I was exhausted, frustrated, scared and very unhappy. 

I started the bioidentical hormone protocol in September 2006.  Dr. Carr started me just on progesterone at first, so that we could make sure I could tolerate the hormones well, and if anything was causing unwanted effects we knew what was causing it (bioidentical hormone optimization is as much art as science).  I use progesterone cream (prescription strength) and started with it 3 times a day.  Within 10 days I knew something was happening------and it felt amazing.  First of all, I had far more energy than I had had in years, and with more energy I was more motivated to really work on coping with the ADD.  Secondly, I all of a sudden realized I was reading more, which meant I had more concentration!  As someone who is a huge book lover and has an insatiable curiosity about the world, this just blew me away.  I spoke with Dr. Carr about 3 weeks after I had started the progesterone, and I so clearly remember him saying to me "you even sound more focused on the phone!"  I asked him about discontinuing the Concerta, and over about 4-6 weeks, we worked together to wean me off the Concerta.  Never, and I mean never, go cold turkey off a drug, and ditto, never, never wean off a drug without talking to your healthcare provider.  Ever

It's now been more than 6 years since I have taken any form of ADD drugs, and I have never looked back.  I am also off 5 other medications (including all antidepressants) and I know just not having all those toxic substances in my body also help to clear my mind and be of additional help in managing my condition.  Let me be clear, progesterone does not "cure" someone of ADD/ADHD, but it gets to the underlying cause of the disease (thought to be an overproduction of adrenaline, which is reduced by the hormone balance) and makes it far easier to cope with. 

Do I still exhibit symptoms? Sure!  I'm still somewhat of a daydreamer, I have to make an extra effort to prioritize and not procrastinate, and I often tell people when I first meet them that if I break eye contact with them, I'm not being rude, it's how I focus/refocus.  I'm very aware of it, and I work on it all the time.  My knitting friends will tell you my most obvious manifestation is that I have at least 4 knitting projects going all the time (right now it's a man's sweater, a pair of bed socks, two shawls, and a scarf-----sigh), and I have tried nearly every craft imaginable at one time or another in my life.  I usually am reading two different books at once, one fiction and another non fiction, if I didn't consciously control myself, I'd have 10 different books laying around the house half read.  I've edited and reeditied this post at least a half dozen times trying to stay on message. 

Are there gifts that come with this condition?  Absolutely.  I am very creative, have a very quick mind (and a mouth to match, that's not always a good thing but it's who I am), I have as I have aged become a better multitasker.  I've been known to hyperfocus, sometimes that's good when something needs to get done and have my undivided attention, sometimes it's a curse.  Most of us with ADD/ADHD have above average intelligence, that's not bragging, that's just fact. 

If you suspect you may be ADHD/ADD, please see and talk to your doctor.  If your doctor dismisses you, find one who will take you seriously.  There are a number of books on the market on ADD/ADHD in adults, I just downloaded Your Life Can Be Better by Douglas Puryear---- I will let you know after I have read it what I think (it's available for the Kindle/Kindle app right now for $1.99)