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Copernicus
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05 Mar 2017, 1:00 am

Hey all,

I was just diagnosed with ASD and ADHD. The psych has prescribed ritalin for the ADHD and I've just started using it. I'm also trying to read up on complementary strategies, like ADHD specific organisational methods. Together with my previous general and depression diagnoses, this seems to make quite a lot to manage.

Just wondered how other people here manage their comorbid ADHD and also having a mix of other diagnoses as well as being on the spectrum. I'm not quite sure whether I should try and see one as primary, or really just approach life on a problem, by problem basis. What do you do?

Thanks!



Lost
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05 Mar 2017, 6:02 pm

I've just been officially diagnosed with ASD, ADHD and Dysthymia so I'll be interested to see if taking Ritalin makes any difference for you.

I was fairly certain about the ASD and Dysthymia before the diagnosis but the ADHD was a new one for me, still trying to adjust to that. To me ASD and ADHD overlap a fair bit so didn't consider it could be diagnosed / treated separately.

Are you aware of how ADHD impacts your life and what do you hope taking Ritalin will achieve?

I have lived with untreated ASD and ADHD all my life so it's all I know but I probably subconsciously compensate for it to an extent.



MissAlgernon
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05 Mar 2017, 6:15 pm

How do I manage... With difficulty. Sensory issues are even worse with that. It's difficult to work at home and focus, I need to make the room look like a prison cell LOL.
I had medications before, but I stopped almost all of them. I noticed that I started having memory issues because of them, as well as other symptoms such as my hands shaking. Now all I've got is caffeine and beta-blockers, which were prescribed for my migraines but it helps with ADD too. For the rest, it's all about a daily routine, planned work hours, planned alarms on my watch or cell phone, posts-its sticked everywhere, and people who were explicitly asked to remind me stuff to focus on and to not do things that would overstimulate me.



Copernicus
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05 Mar 2017, 9:31 pm

Lost wrote:
I've just been officially diagnosed with ASD, ADHD and Dysthymia so I'll be interested to see if taking Ritalin makes any difference for you.

I was fairly certain about the ASD and Dysthymia before the diagnosis but the ADHD was a new one for me, still trying to adjust to that. To me ASD and ADHD overlap a fair bit so didn't consider it could be diagnosed / treated separately.

Are you aware of how ADHD impacts your life and what do you hope taking Ritalin will achieve?

I have lived with untreated ASD and ADHD all my life so it's all I know but I probably subconsciously compensate for it to an extent.


Hi Lost,

Hope this isn't too much of an infodump! Don't think anything can get rid of that habit.

Same diagnosis as you, except I have anxiety problems as well(GAD). I was previously seeing a therapist who was convinced that my problems were the result of childhood psychological trauma, so both the ADHD and ASD diagnoses have been a bit a surprise to me. A change of diagnosis in effect, although I've been having workplace communication problems, depression and anxiety for a long time. They've provided a completely new way to interpret my difficulties. I went to see a psychiatrist to review my anti-depressant and he re-diagnosed me. I suppose its fair to say I was misdiagnosed previously.

Yes I think its right that there seems to be a fair degree of overlap between ASD and ADHD and I gather that they couldn't be diagnosed in the same person until the latest version of the DSM (DSM V). I think that in practice for me it means that I've been doing a bunch of reading about ADHD and ASD, looking for some strategies that might be helpful to improve my quality of life from both directions. However there's not much written, as far as I've found, on what its like managing both diagnoses at once.

So far taking ritalin (its only been for the last few months), I've found that its helped me to refocus, or get back on task more easily. My partner has also said that I tend to go of on fewer tangents when I talk and I seem a little better organised. So I can't say its been a world shaking experience so far, but then I spose you can't expect too much with multiple other problems. I get the impression that for some people with a primary ADHD diagnosis, it can be really life changing. Not so far for me.

I've also lived with both conditions unmanaged for my whole life. The overall outcome has been a fairly patchy education and employment history marked by a lack of planning and general foresight and lots of problems paying attention to details which I found boring as well as lots of problems managing stress and change. So executive function problems I suppose. I also found dealing with workplace conflict and negotiation and office politics really hard at times. I'm currently not working (I needed time out). But that said I think I've been much luckier overall than a lot of people who's stories I've read on Wrongplanet.

:)



Copernicus
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05 Mar 2017, 10:32 pm

MissAlgernon wrote:
How do I manage... With difficulty. Sensory issues are even worse with that. It's difficult to work at home and focus, I need to make the room look like a prison cell LOL.
I had medications before, but I stopped almost all of them. I noticed that I started having memory issues because of them, as well as other symptoms such as my hands shaking. Now all I've got is caffeine and beta-blockers, which were prescribed for my migraines but it helps with ADD too. For the rest, it's all about a daily routine, planned work hours, planned alarms on my watch or cell phone, posts-its sticked everywhere, and people who were explicitly asked to remind me stuff to focus on and to not do things that would overstimulate me.


Hi MissAlgernon,

I get where you are coming from about working at home. I've been an obsessive book collector for ages. But I've found that shelves and shelves of books are almost as distracting as the internet. Not "Oh look a bunny!", but oh look there's a book that looks really interesting, but has nothing to do with what I need to get done. Hours later..... I've put a bunch of books into storage and gone electronic. Kindle.

I sometimes also spend far too much time on whatever is currently my particular obsessive interest. But I spose that's an aspie thing.

Luckily I've generally been quite lucky with side effects from medications. The only time I've had memory problems was years ago, when I started taking anti-epileptic medication and had to change to a different med. So currently I'm taking anti-epileptics, an anti-depressant and the ritalin. See how it goes I suppose.

I've never tried medications for migraines, although I sometimes suffer from them as a result of stress. Are beta-blockers useful for you? They work for ADHD as well?

Having a good routine is always helpful for me too, although I suspect it may occasionally be a pain for other people. I'm going to try and use a low tech solution: a daily diary. I've tried to get these kinds of systems going before, but they always have a way of falling apart over time. Doh! I kind of maintain the broad outline of the routine obsessively, but details still fall of the edge! I'm lucky I also have a partner, who keeps me organised some of the time.

BTW, I like your brain icon. :)



Lost
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06 Mar 2017, 5:18 am

Interesting to hear that so far, taking Ritalin has not had a significant impact for you. I'm wary of medications in general so if the effects are minor I'd rather avoid the complications.

I'm somewhat insulated from the complications of the real world and don't have a partner as a point of reference so I tend to be unaware of many of my difficulties. While I do have issues at work, I get around them by working part time and avoiding most of the situations that I have trouble with.
Having said that, I have been fortunate that I'm somewhat sheltered at work, but that is not a situation I can rely on. It's been a matter of luck more than anything that I have been able to continue as long as I have.



Copernicus
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06 Mar 2017, 5:39 pm

Lost:

I think my view of medications is really pragmatic. I figure that even if they can help a little bit, that's great. I'm not sure if the psych who diagnosed you has suggested trying meds, but if you have doubts you should just be totally up front about them with the psych and talk them through. I think lots of people get a bit stressed about the idea of psych meds if they have never had them before. I always worry about side effects with new meds.

But to be truthful different people react in different ways to the same drugs. You really need to just try and see how it goes. If you are prescribed ADHD meds there will be scope to discuss effectiveness, dosage etc with your psych over time. They won't just prescribe and leave you to work it out by yourself.

In doing my own research, I've also found a couple of fairly useful books about ADHD friendly time management and organising strategies as well:

https://www.amazon.com/gp/product/B00N3 ... UTF8&psc=1

https://www.amazon.com/gp/product/B01LY ... UTF8&psc=1

I figure that ADHD and Aspergers both come along with executive function problems, so any ideas about supporting organisation in ADHD are probably also Aspergers friendly!

There is also an ADHD specific forum. Not sure if anyone has mentioned that to you:

http://www.addforums.com/

They have sub-forums on adult ADHD, but also a bunch of medication specific forums. Very helpful. Might be a good place to talk through some of your doubts about meds as well.

And of course I think sharing on here is also really helpful.

Take care. :)



MissAlgernon
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06 Mar 2017, 8:37 pm

Copernicus wrote:
Same diagnosis as you, except I have anxiety problems as well(GAD). I was previously seeing a therapist who was convinced that my problems were the result of childhood psychological trauma, so both the ADHD and ASD diagnoses have been a bit a surprise to me. A change of diagnosis in effect, although I've been having workplace communication problems, depression and anxiety for a long time. They've provided a completely new way to interpret my difficulties. I went to see a psychiatrist to review my anti-depressant and he re-diagnosed me. I suppose its fair to say I was misdiagnosed previously.

Sounds like a psychoanalyst... I'm not saying that all psychoanalysis is bad, but it's definitely not a reliable way to be diagnosed. It's more the kind of person to meet if you want to learn to cope with "side effects" like anxiety. Almost everything with a neurological origin will be labeled as a mental disorder by psychoanalysts and it's always your mom's fault or whatever. I got labeled with a bunch of mental disorders (I even met a psychiatrist who I learned later labeled all people with cognitive disorders as schizophrenic) before I eventually got redirected to a neurologist and got the right diagnosis, treatments and strategies to manage your daily difficulties that really do work because they come from serious research. A specialized neurologist is the most helpful doctor by far.

Copernicus wrote:
MissAlgernon wrote:
How do I manage... With difficulty. Sensory issues are even worse with that. It's difficult to work at home and focus, I need to make the room look like a prison cell LOL.
I had medications before, but I stopped almost all of them. I noticed that I started having memory issues because of them, as well as other symptoms such as my hands shaking. Now all I've got is caffeine and beta-blockers, which were prescribed for my migraines but it helps with ADD too. For the rest, it's all about a daily routine, planned work hours, planned alarms on my watch or cell phone, posts-its sticked everywhere, and people who were explicitly asked to remind me stuff to focus on and to not do things that would overstimulate me.


Hi MissAlgernon,

I get where you are coming from about working at home. I've been an obsessive book collector for ages. But I've found that shelves and shelves of books are almost as distracting as the internet. Not "Oh look a bunny!", but oh look there's a book that looks really interesting, but has nothing to do with what I need to get done. Hours later..... I've put a bunch of books into storage and gone electronic. Kindle.

I sometimes also spend far too much time on whatever is currently my particular obsessive interest. But I spose that's an aspie thing.

Luckily I've generally been quite lucky with side effects from medications. The only time I've had memory problems was years ago, when I started taking anti-epileptic medication and had to change to a different med. So currently I'm taking anti-epileptics, an anti-depressant and the ritalin. See how it goes I suppose.

I've never tried medications for migraines, although I sometimes suffer from them as a result of stress. Are beta-blockers useful for you? They work for ADHD as well?

Having a good routine is always helpful for me too, although I suspect it may occasionally be a pain for other people. I'm going to try and use a low tech solution: a daily diary. I've tried to get these kinds of systems going before, but they always have a way of falling apart over time. Doh! I kind of maintain the broad outline of the routine obsessively, but details still fall of the edge! I'm lucky I also have a partner, who keeps me organised some of the time.

BTW, I like your brain icon. :)

I agree about books, it's the kind of thing to not keep on your desk if you might be distracted by them. The thing is that to work efficiently, I need to make access to procrastination very difficult. My personal issue is with the computer (I love programming, if I start I won't stop for hours, it's 100 times worse than even video games, maybe because it's the only thing that I find relaxing as my brain fully "gets it" if you see what I mean). So I've done a few thing to prevent me from accessing parts of the computer that would lead me to procrastination. Or make it very difficult, at least. I let my window shutters closed so I can't watch birds outside. My cell phone is offline. I let notifications and alarms remind me of the work I need to do everywhere. Very restricted Internet access, only for what I need for work. I have a dual boot on my computer and I take care of not working and programming on the same partition so if I want to code something with all my tools, i'm forced to reboot. I work at night and with just a night light because light bothers me and I'm more stressed during the day. Etc. I just keep music on because it just gives me the right amount of stimulation to focus better, to the point where I feel I need my headphones to dive into work now.
Beware of serotonergics such as antidepressants on long term, in my experience they really don't help with memory. Even after withdrawal. They don't always cause damage, but they have the potential to do it, especially after many years of use, although it depends on the drug in question.
Beta-blockers reduce some heart issues caused by performance anxiety, because I somatize a lot and my heart suffers from it (my heart is already not very strong and it gets worse when I'm anxious, almost all the time). But it's really not the kind of medication to even think about taking for ADHD, unless if you have diagnosed cardiovascular problems like bad blood pressure, arrhythmia or severe migraines. It's more coffee that helps me focusing and my memory themselves, rather than just stress, and it's relaxing, it really helps.
Thanks about my avatar :) I love cartoons.



Copernicus
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08 Mar 2017, 2:15 am

MissAlgernon:

It seems to be so touch and go getting the right diagnosis. But I suppose its no different to trying to work out the best medication, or treatment for physical problems. Still annoying though. Grrrrrrrrrrr! Lots of people on Wrongplanet seem to go through a lot of pain to get the right diagnosis. Seems to be a big problem.

Hmmm I wonder what absorbs me most? I think it tends to be getting really caught up researching special interests. It used to be philosophy when I was studying, but in the last few years it mostly computing (I have a pretty strong interest in Linux and open source) and aspergers, adhd and psychopathology. But I'm also a bit of an anime fan: Miyazaki and pop culture/tv in general.

At times even when I'm reading/working I find it really hard to avoid going off and googling something that was just mentioned in passing in whatever I was reading. I need to turn of the internet when I'm trying to work as well I think.

I must admit staying very organised is a major source of stress for me and the more stressed I become, the more my organisation falls apart. :) Its always really hard work. Focus in general erodes as well. Kind of a vicious circle.

I like music as a focussing tool as well. I'm a big fan of the hours long sets of music you can find on youtube. Even with ritalin I really can't reduce my need for movement. I often pace while I read and play with fidget toys like this: https://www.youtube.com/watch?v=5-Qt8Ui-29M I'm never sure if this improves focus. It kind of seems to though, so long as other people aren't around.

I need to find myself some kind of useful alarm and timer system as well. Any suggestions, or do you just use your mobi? I like the idea of clock like timers.

I also of experience my anxiety as physical symptoms like severe neck and shoulder and leg pain and shortness of breath. Sounds like migraines have been quite a bad problem for you.

Anyway thanks for sharing and reading!



MissAlgernon
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08 Mar 2017, 2:39 pm

I combine the cell phone, the computer and a watch for alarms. Because I need to turn off one or several devices sometimes when I know I'm going to go on Internet and I can't help it (which is something I currently should do... I should be working right now and I'm on WP instead ! LOL). I think it's necessary to install alarms on several devices including a clock because it's essential to have complex alarms and reminders, but OTOH it's almost impossible to have them all on one device that's 100% offline. I'm now thinking, maybe something like an Apple watch can be a good compromise, to program something on it without falling into the addictive computer / smartphone activities trap, but I haven't done research on it yet. It sure is more effective than a paper agenda to me because I need sound reminders. Written reminders, I'll read them but 3 minutes after I'll have forgotten them already. At least with sound reminders, it's right now, not later and it will ring as many times as necessary.



Benjamin the Donkey
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08 Mar 2017, 11:48 pm

My son (age 9) has AS and ADHD. The AS is not a big problem, either in school or at home (I'm the same) but the ADHD is. Without Ritalin he simply can't get through a class--jumping around, interrupting, climbing out the window. With it, he's just an unusually excitable, very smart AS kid. So for us it works very well.


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Copernicus
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09 Mar 2017, 10:13 pm

MissAlgernon wrote:
I combine the cell phone, the computer and a watch for alarms. Because I need to turn off one or several devices sometimes when I know I'm going to go on Internet and I can't help it (which is something I currently should do... I should be working right now and I'm on WP instead ! LOL). I think it's necessary to install alarms on several devices including a clock because it's essential to have complex alarms and reminders, but OTOH it's almost impossible to have them all on one device that's 100% offline. I'm now thinking, maybe something like an Apple watch can be a good compromise, to program something on it without falling into the addictive computer / smartphone activities trap, but I haven't done research on it yet. It sure is more effective than a paper agenda to me because I need sound reminders. Written reminders, I'll read them but 3 minutes after I'll have forgotten them already. At least with sound reminders, it's right now, not later and it will ring as many times as necessary.


On the principle of keeping it simple I'm going to try out a paper diary combined with something like this: http://www.gymboss.com/features/ to keep me aware of the passing of time and remind me to check whats coming up next in the day. It has the benefit of not being network connected too.

See how it goes :)



Copernicus
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09 Mar 2017, 10:28 pm

Benjamin the Donkey wrote:
My son (age 9) has AS and ADHD. The AS is not a big problem, either in school or at home (I'm the same) but the ADHD is. Without Ritalin he simply can't get through a class--jumping around, interrupting, climbing out the window. With it, he's just an unusually excitable, very smart AS kid. So for us it works very well.


Hi Benjamin (neat nick btw!),

I've found that so far it has helped improve my focus and ability to stay on task. So that's been great. Its an odd feeling though, somehow the effect of the drug is very covert for me. Very slightly improved mood and a calm focus and greater ease pulling back on task.

I still have problems interrupting during conversations and one on one meetings sometimes though. Just can't seem to get the flow. Not sure whether its an ADHD impulsiveness thing, or an Aspie turn taking issue, though. I also still fidget and move around quite a bit. But again, hard to know if that's ADHD, or Aspie. I might see if I can try a slightly higher dose of the med and see whether there is an improved response.

This is on a tangent, but did you get diagnosed after you found out your son was on the spectrum. I gather that's a common late diagnosis pathway.

:)



248RPA
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11 Mar 2017, 7:50 pm

I don't. That's why it took me 5 hours approximately to do one question of a homework page today.


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redrobin62
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12 Mar 2017, 1:45 am

I have an autistic friend with ADHD. In the past his management strategies involved drugs and alcohol; these days he smokes cigarettes and vapes like they're going out of style. His anxiety level is very high, though, and that's how he manages life. He's also quick to anger, so in his case, the smoking is better than him going to jail for some petty nonsense (which, incidentally, has happened in the past). He does see a psychiatrist and take meds, but I don't know how effective that is.



Copernicus
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12 Mar 2017, 6:39 pm

248RPA wrote:
I don't. That's why it took me 5 hours approximately to do one question of a homework page today.


Hi 248RPA,

Your nick reminds me of C3PO, an excellent association. Hey sorry to hear about that. It really sucks. I hope your day is going a little better today!

:)