# Is there really a kind of therapy?



## al_krayno (Dec 23, 2004)

ok, back to the question of is there really a kind of therapy? but in a different way.  I've seen billions of docs through out my life, and billions of psychologists, along with billions of hospitals.  Strangely, the therapy part sucks.  Its been mainly about the medication, and then let me go and and fend for myself.  But I do think I need a psychologist or therapist, mainly because you see them more often then the psychiatrist.  But then I go through millions to find the right ones, but I don't know what i"m trying to find.  At the same time, I need them to just know me more of whatever my problem is, so that when it comes to medicating me, are we even on the right disorder to treat.  And also, cause the me or medication changes after 3-6 months, a major change is needed.  So help me, I have heard that there are different types of therapy like cognitive therapy and such.  I've already done a bit of some random types of therapy, I'm sure of it cause they all are so different.  More like anger management, or just rambling therapy.  Now, I've lived in this psych world for over 10 years, am coming to the conclusion that medication is the only way I'll get anywhere.  But I can't be living it that way.  Always monitoring myself till I see the doc in 1-3 months later, to know if I'm hallucinating, going manic or depressed, or just have a plain rebelious anger problem and stuck in the childhood times; but half the time I don't relize it till its a huge scene somewhere.  But I just moved to a different town, got my insurance and asked for who to see for psychologist or counseler.  After they sent me to one guy, and he turned out to be the most horrible psychologist I've ever met.  I return for another name.  They have a huge list, then they ask, what am I looking for and type of therapy? for what treatments? what are my diagnoses?  I don't know what to say, without rambling off everything I know that tells them nothing.  Does anyone know what I'm suppose to ask for?, or what are my options?  Time is running short on this cause I decided to take my time on figuring out what I need to do.  Its 4 months later, and I'm struggling with something now.  I can't hold a job or stay in school because of a random chrisis every few months, and barely a support group, and depending on medication.


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## David Baxter PhD (Dec 23, 2004)

*ADHD, Tourettes, Depression, Anxiety, OCD...*

Al: You indicate that your diagnosis may have changed over time. What is the most recent diagnosis or the most frequent diagnosis? What medications are you taking currently again?


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## al_krayno (Dec 24, 2004)

*ADHD, Tourettes, Depression, Anxiety, OCD...*

Most recent diagnoses with doctor I have now is ADHD, Tourette syndrome, OCD, and I think he is questioning if I either have depression or Bi-polar; because the doctor before this one (before my move) said I was bi-polar while therapist said I was schizoid personality, PTSD, Depression (possibly bi-polar), Intermittent explosive disorder, ADHD, learning disorder (reading), tourettes, ocd, and anxiety.  

Most frequent diagnoses was Depression, ADHD, tourette syndrome, OCD, and anxiety, but not sure if PTSD was a frequent diagnoses and if aspergers was a frequent diagnoses. 

Current medications is Ultram (300mg daily) for OCD for past 3 months, ritalin (10mgx3 daily) for ADD for past 6 weeks, and Lamictal (12.5-25mg) that is probably for rage or bi-polar or mood for past 4 months.  But past I've taken these meds before and experienced that sometimes they work great then suddenly do bad within avg of 6 months; or that I take them again, and its a different reaction.  Or they just quit working after 3months.  I do keep a medication journal to keep track of these for the doctors.  So I wonder, is it possible that chemicals in brain change often that make the need of meds to be changed so often, or do meds bring out other disorders, or does body get used to a certain chemical but can take again later on; and is change happen so quickly?  

And current problem now, that I'm going to talk to doctor about on the 27th is I'm still having trouble to sleep when I take last dose of ritalin at 3pm, anxiety was exploding but then vanished when finals ended, and that tics increase at night probably when ritalin wears off.  But my mood has been ok lately, no rages or fights in 4 months.  Depression was getting bad, but is starting to do probably because school is out or my family is home for holidays or something.  But overall, I think things at the moment are fine or at least real close with the combo of meds, just still need slight changes.


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## David Baxter PhD (Dec 24, 2004)

*ADHD, Tourettes, Depression, Anxiety, OCD...*

Interesting. I have a client with a similar history and similar multiple diagnoses who has had great difficulty finding a combination of medications that helped for more than a few weeks. I have always been doubtful about the various diagnoses that have been given to him (bipolar, ADHD, major depression, OCD, SAD), although one can certainly see components of all of these disorders and of course it may well be that more than one is present. The difficulty is that with multiple taking medication to treat one exacerbates another -- e.g., the Ritalin may help with concentration but tends to aggravate anxiety, OCD, or tourettes.

There is an interesting interview with Dr. Alan Peck here on OCD Medications and Therapy where he discusses some of his views.

What I can tell you is that my client is currently trying the Neuroreplete program. Do a search for that term on the internet and you'll find a lot of hype (if you believe what you read it can cure everything) and web sites offering online sales of the components, but my advice would be don't try to do it yourself and learn something about it first -- to find yourself a doctor who knows something about it and can anctually monitor how well it is working. I don't know yet whether this is going to be the or even an answer for my client but it is not hurting him anyway and it may be helping. One drawback is that it is rather expensive.

You can read about Neuroreplete here.


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## al_krayno (Dec 26, 2004)

*ADHD, Tourettes, Depression, Anxiety, OCD...*

ok, I read those to sites you said.  Dr. Alan Peck interview was really long, but I actually read it.  I just relized I haven't tried that Anafranil.  The Neureplete, sounds like it could work.  Just need to find a doc that knows about it.  And also need some money too.  

This break is still going ok.  People starting to seriously get on my nerves, and I have no space to run to.  But so what, its probably me more then anything.

I have another concern coming up, I have a trip coming up with the students for a whole week in 2-8th of Jan.  Some things I want to be sure if under control with medications; and because of reactions from past meds, I'm a little afraid of changing anything before the trip and dealing with it out of town with thousands of college kids to a convention.  I see the doc on Monday to let him know my concerns.  But my question to you guys is what do people do when they go out of town with having a few serious diagnoses and serious medication reactions? Do you call the doc, or do you ask the doc to take extra meds for emergency meds as needed if something comes up (ie rage, depression, anxiety, dangerous hallucinations)?  Do you hand those pills to someone else if you do have problems with suicidal tendencies or rage or something from past?  Who do you let know about it?  who do you not let know?  How do you ask for help without having them babysit you as an adult?

I did meet with a couple of people on the group to let them aware of these stuff, and ask them if I should even go.  They said I should go, but the next question was, what do they do if things go wrong?, rages or attacking, or severe depressed or even hallucinate or delisions.  If nothing happens then that is great, but just to be on the safe side, they want to be aware on what to do.  and I honesly don't really know.


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## David Baxter PhD (Dec 26, 2004)

*ADHD, Tourettes, Depression, Anxiety, OCD...*

If you had a serious illness, or even something like a bad 'flu, would you go on this trip? What are the implications for your career of NOT going, if any?

I usually advise people who are about to begin a medication change to postpone trips out of town whenever possible...


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## al_krayno (Jan 8, 2005)

*update*

I talked with the leaders about the trip.  They still encouraged me to go and gave me lots of accomodations.  They gave me second floor of hotel for use of stairs or if others have to drag me there.  They talked with 2 other people who would be my roomates to understand, and even help me out, since one was in training to be a nurse.  And they kept an eye on me, but not to make me feel like I was 12 either.  I ended up with still on Lamictal on 37.5 mg, Ultram 100x3, Ritalin LA 30mg morn, added 10mg ritalin once or twice depending when LA wears off.  I ussually needed it twice.  And for as needed for rage or uncomfortable tics was risperadol, which I didn't need to use.  And for panic attacks I had ativan, which was really helpful.  Though I had the roomates help me on making sure I didn't over do it, since I did one day.  But the week did go ok.  Had one minor trouble one evening, but nothing big or obvious, so it was ok.  But I also feel the meds feel more better.  I'm able to survive on little sleep or more sleep.  I don't feel agitated or rage outbursts.  Depression or emotional cry spells still needs work, but doc said he is slowly increasing Lamictal for that.  The focusing is doing great now, I have conversations and keep on track, and for first time years, I was able to play those long board games and even hours of Game boy games.  And this week had lots of long sitting and listening and I actually did it.   Now, just a question of things sticking this way, that maybe this is the right combo for me.  But I"m glad I went on this trip.  I was worried about how people were going to be with me for knowing this, but turned out ok and I had fun.


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## ThatLady (Jan 8, 2005)

*ADHD, Tourettes, Depression, Anxiety, OCD...*

That's wonderful to hear, hon. I'm so glad you were able to go and enjoy yourself, and that things are starting to fall into place for you! )


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## al_krayno (Jan 24, 2005)

*nevermind*

things once again changed.  I thought I was ok, but then the stess hit.  First school started, but just 2 classes.  But I didn't get into one I wanted.  Oh well, I have to others to fall on.  Then next day I got a job.  Put lots of hours in.  Except 3rd day I broke down.  In past I break down at jobs but not so quickly.  I was so breaking down, he said,"go home".  of course that was the last place I wanted to go, so I just kept walking across town.  needed someone to talk to right then, but then again, I didn't know.  After couple hours of walking, I was found by 2 friends, they picked me up, by this point, I had nothing to say.  I was really tired, and didn't care.  So I came back home to sleep.  They said all I needed was a good night sleep.  Next day, I woke up and started up crying again.  I popped extra pills to get myself together, because I need a job.  All jobs are the same.  But I so can't handle little stress or little critizism.  Other people, specially work people don't understand.  My friends, I don't really want to tell them, I think its more of a professional person area to go into.  I do'nt have a counsler, and I can't find them at need at midnight.  I can't go to the hospital, because of everything I will lose.  Insurance and such.  My meds seem fine, or they did, and I think its more stress.  but how can I get over it so quickly.  Or am I forever to just sick with having tons of free time on my hands.  But I need an income of something.  Jobs are not optional,  you just have to do them.  I would be ok, if I was mentally stable.  In fact, things would be much better.  But now I'm limited.  I cannot talk to my boss about these things.  He doesn't know, and I observe him as a guy that really doesn't understand these kind of things.  So, my question is, for next time I have break downs from work.  What kind of people or place shall I search to find at those times, even if its midnight.  I'm not talking suicide hotline, I'm just talking.. I don't know.. something, something to crash at and go ahead and explode.  Or what is the suggestion for people with MH on limits of stress.  I can't find mine.  I thought work would be good for me, instead I can't stop crying all the time.  I push everyone away.  I'm on same meds as before, nothing changed.  I keep bugging people to help me find a counsler in town, but that keeps getting put off.  They are busy people, I can't just push them to help me.  Cause I can't do it on my own, I tried, and ended up with a real quack.  How do people manage their own stuff?


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## al_krayno (Feb 5, 2005)

*new update, if anyone ever interested to read.*

well new update on al_krayno.  Things with thw work is not any better, but not worse either.  I'm still at the subway job there for about 20something hours all on weekends, and I got another job for the weekdays for another 20 hours.  I still got my 2 classes, which I'm completely wasting time in now, since I can't seem to get motivated to study at all.  I still got my pleasures of a couple free art classes twice a week.  And I got my dog and rat, that I've completely neglected lately cause I'm never home.  They miss me, and I miss them.  But everyone around can tell I really should not be doing all that stuff, I'm going to kill myself trying to do all that.  I'm also very stressed out lately.  So no matter how meds are, its the stress.  So I've decided to let the subway job go, but now I've got another problem.  I'm really afriad to telling my boss.  

Other then that, the meds are difficult once again.  I started doing ok with regular ritalins and ritalin LAs.  I've been on all ADD meds and those are what works,  problem is, they only last so little at a time.  And when they wear off, my tics return and can be worse.  Docs idea is, have meds like ritalin effect all day, that I would be asleep before tics took over again.  Well, we haven't found that yet.  Last trial was a combo of 10mg of short ritalin with 30mg ritalin LA at same time, and then continue the short acting later in day if needed, but I dont know when that is, or when to not take it.  And it still the problem of, ok, I'm back to wearing off at somewhere between 12 and 3.  But my focus and stuff was really good at those times.  And depression too seems treated with ritalin.  Then I go in complete irratability at wear off too.  Anyways, he then switched to Metadate, I guess its got that quick affect after taking it like a short acting ritalin and the rest goes for rest of day.  I completely went back to problems.  It was like not taking it at all, except for morning spurt was a little there.  But my tics came quickly about 10-12 am, earlier then the LA.  Then I completely lost my concentration period.  I used to be able to play video games or do anything for lengths of time, but then I completely stopped.  I couldn't even read my books either.  And I became cloudy minded and just frustrated.  Along with my tics were still going active.  So I just don't know what is left to do.  The ritalin really really helps, but the tics really don't help afterwards.  And the actually ritalin does not last long, so I go up and down, and have to schedule my day based off that.  That is just too weird.  so what are other options that people go to doing?  I'm trying to call him about it, but I'm just wondering, what other ways do people do with these quick acting, but not long enough pills?  I'm no doctor, but damn, I know those damn pills a little too well.  Everything else seems under control, except for stress stuff, but still, its just the ADD and tourrettes part so frustrating at the moment.  I'm so handicap with the ADD not helped.  The tics, I don't care about really.


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## Cat Dancer (Feb 5, 2005)

*ADHD, Tourettes, Depression, Anxiety, OCD...*

Well I just wanted to let you know that I read your post. I don't know anything about the medications though. Can you ask your doctor for the name of a therapist? 

I am sorry that you're having to deal with all this stress.


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## David Baxter PhD (Feb 6, 2005)

*ADHD, Tourettes, Depression, Anxiety, OCD...*

There are some new non-stimulant alternatives to ritalin or dexedrine that may not trigger the tics as much -- have you discussed these with your doctor? Alternatively, have you thought about asking for a referral to an ADHD-Tourettes specialist?


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## al_krayno (Feb 7, 2005)

*my reply*

thanks for the replies by the way.  About the non-stimulant meds, I have tried the strattera, and clonidine and tenex.  Is there others besides those.  It seems the ritalin is the only that makes a huge difference.  And strangely, while in effect, my tics go away. its afterwards it comes back.  Is that the usual you guys hear about?  I have been trying to call my psychiatrist about med problems to help sooner.  Last I talked to him, he did say, he might try the abilify.  At last TSA meeting, I noticed all the kids were on that, and they all seem really better from thier tics.

About TS-adhd specialist.  They have those?  I have seen a nuerologist, and he told me, that honestly he didn't have any more ideas then what I have tried. And I saw another one, that all he did was say, I shouldn't be on zyprexa, because it can add the tardive dyskinesea, another movement to fix another.  So he removed that.  I could check with the Tourette syndrome association of this city to help me find someone that is specialize in those things.

Therapist, people are helping find a good one for certain things along with my insurance list.  I have been giving some names already, and soon will be calling them between classes.  

But those are good ideas, I'll definatly look at those things.


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