Questions for Dr Joe

Questions for Dr Joe

Key question: what sort of therapy do I need in parallel and who is the right person?

Joe's going to send me some reading material. I'll check back with him in a month. I'm correct - I have habits to reform to stop me reverting back to previous behaviours, that were previously ADHD symptoms or coping mechanisms but are now just habits.

The treatment is like an antibiotic course - when you feel better after a few days you have to complete the whole course (ie the meds and the coaching/therapy and behaviour change) and not just stop working on the treatment. 

What will Ritalin help with and what will it not help with? Eg I assume my short term memory hasn't magically got bigger?

Yep, it'll help with some things but not others. Emotional regulation and self image will not be 'treated' but I do have more headspace to manage those myself.

What happens if I stop and start Ritalin, do I need those 30 mg tabs to wean myself on again?

It's a great idea to take the weekend off, or take a day off, to let the ritalin wash through your system. Some people take it once a month say. So stopping and starting Ritalin is a good idea.

Long term side effects? Will i become tolerant of Ritalin over time, will it become less effective/will I have to take more?

Didn't really get an answer to this but the impression from the conversation is no, you can be on Ritalin long term no problem. Elevated heart risk is the only non-trivial issue.

Can I have a beer after work? Can I have seven beers after work?

Sure!! The risk is primarily physical (heart risk) not mental (mixing uppers and downers). 

Do I really have ADHD?

It's a good (in fact the best!) indication of ADHD that Ritalin isn't a fun upper drug for me. That shows that it's balancing my brain chemistry rather than boosting it.

Psychaiatrists are tough - they have a high bbar to diagnose. That will be why it feels like you're being interrogated rather than helped. If a psychiatrist says you have ADHD then you can be confident you have ADHD. 

6pm feels like 9am and Thursday feels like Monday. Is this cos im stress free or is it the drugs talking?

Not a direct answer but it sounds like a bit of both. The Ritalin will be out of my system by say 12pm so the afternoon is definitely all me. 

Joe used the analogy of a train system that changed tracks all the time and with having to manage constant clashes and delays; the ritalin is smoothing out those tracks so they all smoothly run in parallel.

What does 'titration' mean in this context?

Titration is taking the meds in a stepladder fashion. That's why I've started on 30mg and are moving to 50mg. Also like a plane taking off, climbing from one flight level to another. There might be turbulence to either work through or find another flight level. 

I'm on Amitriptyline for my migraines. Will it interact with ADHD meds?

I didn't ask that one, I need to google it.

What are the five components of ADHD that you just rattled off?

I didn't quite get them down!

Take a look at that graph above.

Five Dimensions of Adult ADHD in Everyday Behavior | Psychology Today New Zealand - isn't quite right because negative self image is definitely one of them. 

Self reflection questions

Check energy levels. Can you concentrate? Do you feel ok to drive? etc.

I feel like the energiser bunny. I can concentrate well and certainly don't feel impaired.

Do you have any headaches or fuzzy eyes?

No

Did you eat today? How much, are you hungry now?

Def eating less and feeling less hungry. I have 5kg to lose so this is a good thing kinda. I will need to closely manage my nutrition.