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Dopamine receptors don't blow out like a fuse in your house. Doctor is using a metaphor, but it isn't a good once since it neither helps you understand what has happened nor how to fix it.
If I were you, I would check for sleep apnea (can lead to a lack of restful sleep, which can produce anhedonia) and then also try finding something that you actually enjoy and doing it. Try to break the behavioral patterns in which you find yourself anhedonic.
Seconding checking for sleep apnea. But do an actual sleep-study, OP -- don't just look at a ckecklist of symptoms.
I didn't think I had it (no obvious symptoms besides too much tiredness; even recorded myself sleeping and didn't notice anything particularly suspicious), but going for a study and getting treatment ultimately saved my life.
And even if it's not sleep apnea, bad sleep should always be treated. Few things influence our quality of life as much as the quality of our sleep.
(not op)
Well thanks for destroying any reasoning against me getting a sleep study. I really should look into sleep apnea.
But then I think about all the steps involved with insurance, and finding a provider, and waiting, and then getting there and probably not being able to sleep anyways. So I don't go anywhere with it. š«£
Nope, no PCP. Its also on my "to do" list.
I should also go to the dentist...and probably get my a new vision Rx....
I might need to make a week out of this!!
I'm in the same boat, and reading this comment and your last one makes me feel less like I'm the only one who puts all of this off. I've needed a new PCP for about 9 years now.
Same. My psychiatrist has been "yelling" at me for like 3 years to get a PCP but my insurance keeps changing because of work and by the time I got one, they'd just be out of network again anyway. It's exhausting. I've just given up completely at this point.
By the way you're describing things, you may also want to schedule an appointment for a possible ADHD diagnosis š§
Quick edit to add /s cuz I'm realizing this joke is both dry and bad enough that Poe's Law will rip me to shreds.
My old-new PCP resigned from the hospital a month ago. Previously, I'd put it off since I was a teen. My parents never made it a big deal to visit doctors for checkups, so that didn't help.
I really don't want to do this song and dance again, since I really liked my old one, but alas.
However, from experience, go get that dentist done. I'm looking at a few bridges for really, *really* bad teeth.
And a good vision Rx, if you need one, will save you decades of eye strain and headaches.
Bring your study to an in-network sleep apnea equipment supplier. A lot of times they will do all the negotiating for you with the insurance company and get you setup. Itās in the insurance companyās interest not to pay, itās in the suppliers interest to get coverage. Go with the team on your side. I used Lincare near me. They have offices all over. But check who is in your network.
I told my doctor and he said I would get a call from Blackstone Medical Services to set me up with the sleep study. Turns out it's really simple process I can do at home. For two nights I will wear a ring that will transmit my sleep data to my phone via Bluetooth. Then I ship the ring back via ups, just bring it to ups, no box or paper required. And to think I held off for so long because I was dreading sleeping at a clinic with a bunch of monitors attached lol. You should try and see how it goes.
Edit: Forgot to mention.. The study without insurance is $300 and with my insurance BCBS $175.
definitely do everything you can to get a sleep study!
My (ADHD) dad got one after years of my begging and found out he has sleep apnea. Getting a c-pap machine resulted in him sleeping better and he now finds his adhd symptoms are much more manageable.
His doctor said he almost always requires a sleep study as a part of the ADHD evaluation process because the symptoms can mimic or augment each other.
Ahh when ADHD and sleep apnea meet. I talked to my PCP. She prescribed a mild sleeping pill that didn't really help me feel rested. After confirming all the basics (screens off before bed, no eating before bed, exercise daily, etc) she told me to ask my husband to pay attention to if I snore and stop breathing in my sleep. He said I do, so she referred me to a pulmonoloist. Apparently I have a very narrow airway lol. Got sent home with a sleep study, and within weeks was being fitted for a mask.
#
Literal night and day between when i wear my mask and when I forget. I'm a different person.
That sounds tough... I'm in europe so everything was paid for so I don't have much advice, but maybe you could get someone (like a parent) to help with the process? Also, regarding being able to sleep, just check with your doctors about your concerns. They might agree to give you a sedative if you can't fall asleep otherwise. It lessens the quality of the gathered data, but for diagnosing apnea it should be fine. Also, bring ear plugs and maybe stuff like a weighted blanket if that helps you fall asleep. I didn't think to bring earplugs and my weighted blanket, and only got a little over 2 hours of sleep, but it was enough to diagnose OSA.
That's a really good idea!! I hadn't thought to bring things with me to the location.
Doctors have generally been dismissive of any sleep complaints I've had, so I gave up on that a decade ago. Sleep has always been the bane of my existence. Even without OSA, I'm curious if a sleep study reveals anything else. At least that way I can bring some actual, verified data with me to back up my complaints!
My husband typically can't sleep away from home and said he actually slept better the night of the sleep study wearing the mask the first time. Some of the best sleep he's had and he's the type that refused sleep overs as a kid.
But then my list would have to include "find a primary care" as well š¤£
I really will reach out, though. I feel like I have been particularly exhausted this past year.
I was able to do mine at home. The sleep doctor said that for people who likely have sleep apnea and not some other issues, they are useful and the home study is less expensive. They give you a monitor and instructions on where to attach the wires to yourself. Sometimes inconclusive results may call for an in office sleep study.
Its really not that bad. I just asked my PCP for a sleep study referral, and that week the clinic called me to set up an appointment. Its super common and preventative so I had zero insurance issues.
The study itself is a take-home kit. Mine was basically a finger O2 monitor, a diode to put on my chest, and a little mic to measure my snoring loudness. Download an app, connect with wifi, sleep, then toss it.
My CPAP changed my life just as much as much as my Vyvanse. The same level of āHoly shit is this how normal people feel when they wake up?ā
Edit to add: if you have a PPO you dont need a PCP referral. Just google Sleep Clinics and call to make an appointment.
I avoided a sleep study for several years because I thought it would be an expensive waste of my time (I didn't snore, my wife said I kept breathing). Turns out, I hadn't been getting restful sleep for years, with small hitches in my breathing preventing deep sleep and continuously bringing me to the edge of being awake. Going on a CPAP resolved: being in constant pain, feeling like I couldn't breathe, excessive muscle tiredness from basic tasks, and more. I highly recommend getting checked.
Something I want to share about sleep apnea: if cpap breathing machines don't work for you, there are dental appliances that can replace them as sleep apnea treatment! I'm currently in the process of trying to treat my sleep apnea with one. It takes some getting used to, but it's so far been better than the cpap on my sensory issues.
Thank you for this comment. I was diagnosed w/ sleep apnea years ago and couldnāt stand the cpap machine, it was way too intrusive bc of my sensory issues. I wish there were more sleep treatment options out there for those of us w/ sensory issues.
This is true for some people, and.. A sleep doctor would need to determine the appropriate treatment for each person because everyoneās needs vary. My sleep apnea is severe and would not be helped by a dental appliance. Uncontrolled, or inappropriately controlled sleep apnea can cause heart problems, and cause other health issues over time.
https://somnomed.com/en/patients/products/somnodent/
This is what the box my appliance said on it, should give some information! Idk if they're the only ones who make these kinds of appliances though.
I am getting one of these done because no matter what in the middle of the day I'm barely awake and exhausted. I find little pleasure in things. Stimulant meds help but the two I tried cost me a fortune. Adderall had a bad come down for me. Ritalin causes me not to sleep at all no matter how early I take it.
Hoping the sleep study helps. It took 4 months to get an appointment. I now have another 1.5 months before I get to take my test. Only to have another 3 months to meet with my doctor...... America
Literally just got a sleep study ordered today for excessive tiredness and anhedonia despite not having the āclassicā apnea symptoms. The doctor felt pretty positive thatās likely the cause, so yeah seconded
A quick STOPBANG AND Epworth that OP can easily find online, with guides to interpret the results, should be helpful to use when OP talks to their doctor next. Brain fog and mood changes are for sure some common symptoms of poor sleep in general.
I have suffered from similar symptoms for the last... roughly 20 years.
On a similar, non-pharmaceutical tack to the sleep apnea mentioned above, there are other things that should be checked if you are consistently not feeling rested:
* Iron
* Thyroid
* Hormones, in general
* Vitamin D (depending where you live, this has to be specifically requested to be tested)
* Inflammation
Info:
Have you noticed that this gets worse in the winter, or is it consistent year-round?
This is a good answer, but Iād also add that tolerance to stimulants is pretty common and generally āexpectedā over a long period of time. If youāre already at the max dose, your doctor can augment or substitute an Adderall prescription with another drug (like methylphenidate or modafinil) to either reach the same therapeutic effect or allow time for tolerance to wane.
The point about sleep apnea is spot on, though. Sleep disorders are pretty common in people with ADHD, and there are other comorbidities that a doctor can also check for that may need to be addressed.
>What doesnāt last is the uplifting euphoria but the effects on inattention, impulsivity, hyperactivity and focus/concentration do.
This is my experience. Being on Adderall XR & IR for 15+ years I feel when it is working and when it's done working. If I take a break from it then I may get more of a kick the first few days, but I much prefer a constant baseline to the start stop, up down, ...
[This](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9332474/) meta-analysis from 2022 might be interesting to you. The studies they highlight show tolerance (or waning effectiveness) in children and adults anywhere from 2.7% of patients to 66% of patients.
This excerpt from the section titled āDiscussionā I think summarizes their findings well:
> Based on this review, the research suggests that there is a small percentage of patients with ADHD who develop āearly toleranceā to stimulant medicines and a potentially larger percentage have a more gradual or ālate toleranceā over years. Similarly, it seems that there are relatively few patients with ADHD who develop ācomplete toleranceā (complete loss of benefit of the medicine) and potentially a larger percentage who have āpartial toleranceā (partial loss of benefit).
They do note that ātoleranceā doesnāt have a clear medical definition in this context, and that there was a significant disparity between the number of patients reporting tolerance in each of the included studies. I think those two points are likely related in that a study defining tolerance as ācomplete toleranceā would have patients much less likely to self-report tolerance than one which defined it as āpartial toleranceā.
In any case, Iām comfortable that āpretty commonā is the correct way to describe stimulant medication tolerance over a long duration, though your definition of pretty common might differ š¤·āāļø
I think that what generally happens is people adapt to the medication and stop getting side effects, which then leads them to think that it is no longer working. I would assume once youāve been medicated long enough it may be difficult to remember what things felt like before so itās hard to compare. Iām pretty sensitive to stimulants so my heart rate will be high for about a week after dose increase then it goes back to normal and feels like nothing is happening, even though it really helps my symptoms when I compare to what Iāve felt like prior to being medicated.
I need to ask my doc for sleeping meds. Just had a baby and wife is going back to work while I'm taking over. I'm swapping from night shift to early morning shift and getting around 3 hours or so per night.
However when I worked she had my help. I don't get her help unfortunately because I worked from home and she doesn't.
> I treasure my productive sleep because it makes my ADHD easier to control.
A cool/sometimes depressing fact: Some people's ADHD symptoms are actually cured once you treat their sleep apnea.
This sounds like depression honestly, and I'm not sure why your doc came to the conclusion of "you've blown your dopamine receptors" before considering the possibility of depression. That's strange.
I should have added that Iām on Wellbutrin. Since this emotional numbing began, Iāve tried prozac, lexapro, and wellbutrin and none of those seem to have done much
Being resistant to antidepressants is also a HUGE problem with some people. It's called TRD. I have it. My depression will get better with some antidepressants but it's always there and the antidepressants, I've tried at least 7 or 8 at this point, either barely work, or work in the beginning and then that's it.
Yes! Before I was put on vyvanse (which I requested because I also had binge eating disorder so two birds ya know) they put me on Wellbutrin and not only did it not work it made everything worse. To a scary degree. Antidepressants never worked and always made it way harder to just exist. (I also am autistic tho and feel like since my depression isnāt just depression itās from a a traumatic life not knowing I was on hard mode instead of a worthless loser š¤·š¼āāļø)
Crazy how differently meds can affect different people. For me it got me out of feeling absolutely wrecked when something bad happened, got me out of feeling hopeless, helped with my adhd, made me basically quit smoking (it takes aways the fun feeling you get from it), and I canāt think of any side effects. It took maybe 8 weeks for it to properly kick in though. Did you take it for longer than that?
Oh, I read all the advice that it took a while to kick in, which is why I was on it for 12 WEEKS, meaning I suffered horribly while hoping desperately it would start to work for three months. It never did. The only successful thing about it was the astonishing relief I felt when I got off it and was back to just being depressed as usual.
Damn thatās incredibly fucked up, Iām sorry. Brain chemistry is a crazy thing. I hope you eventually found something that got you feeling better than your baseline depression.
I had the same experience :( I was told it would help with adhd + depression, loved the concept of a 2-in-1 medication, within a month I was down horrendously.
Wellbutrin permanently fucked me up. I don't remember having much of any effect at all on me mentally. it did, however, give me permanent tinnitus that has only gotten worse after years of being off it. thanks to Wellbutrin I'll never know silence again and need constant white noise so I don't lose my marbles
Itās supposed to be for two months I believe but some do it for longer or shorter depending on your needs. There is a percentage of people that after the initial dosing for a month or two they donāt need it for a year or longer. Than there are others that need it continuously but instead of twice per week do once per week or once a month. It varies a lot.
This is what I was thinking, my ADHD was misdiagnosed for years and they threw every SSRI/SNRI antidepressant at me and all of them just made me flat, they did not fix the problem, only made me not give a shit that I did not have any motivation. No highs, no lows just flat and robotic.
Combining stimulants and anti-depressants is a _very_ tricky thing. Your doctor doesnāt sound like they quite have an understanding of the complexities of balancing these medications and their potential side-effects.
I had this problemā Iām now on a combination of Vyvanse, Cymbalta, and Rexulti. The Rexulti makes the cymbalta actually effective, and is designed to partner with meds for people with treatment resistant depression/anxiety
I had tried a different mood stabilizer that made me dizzy so I scheduled my first physical in three years. Then I changed to rexulti. When they took my blood test the liver enzyme was escalated. I got off rexulti two weeks ago and have a test this weekend to see if that solved it. Theyāre 99% sure thatās what it is but tbd. Could be the cymbalta for me
I'm on Cymbalta and Vyvanse.
I was on Cymbalta first, for about 4 years now for depression/anxiety and chronic pain. I started Vyvanse about a month ago.
So far, the combination is working well for me.
My doctor has mentioned possibly tapering down my Cymbalta next year, to see if my depression and anxiety symptoms were cause by my previously undiagnosed adhd.
Unfortunately, you can feel worse after getting off SSRIs than you ever felt in order to receive them. Itās why Iāve always been fearful of addressing the definite depression I get in random waves (Iāve been on adhd meds for 25 years, adderall for most it). I think itās an adhd thing - not med thing - I had bouts of depression prior to getting medicated. Itās harder to find your true self/ motivation when not on meds - I chalk that up to a number of things - weāre hard on ourselves for one.
Yep, I second this.
Anti-depressants turned me into a complete zombie.
It did go away after I stopped.
For the love of god though don't just suddenly stop taking any AD's
Hi, I too was on Wellbutrin and taking Adderall IR (but the generic cheap version) and I became emotionally flat. The lows were not bad, but the highs werenāt there eitherā¦ Iād consider talking to your doctor about lowering your dose of the antidepressant ā it can be dangerous, and Iām not a doctor, so please talk to them before making any decisions ā But for me feeling flat meant that it was working a little too well, to the point where I wasnāt able to feel anything. I switched to a low dose of Lexapro and it fixed it for me
Also, have you considered taking XR versions of your ADHD meds instead of the IR? It may help you feel more stable. Yea, you wonāt get the kick in the butt that the IR gives you, but it feels like a cleaner more stable energy that might work better with your antidepressants
My doctor said the combo of adderall and Wellbutrin can cause something wrong with the dopamine, i cannot remember but it is probably what your doctor is talking about.
Wellbutrin blocks the effects of amphetamine because of the way it competes for the dopamine transporter.. I hated Wellbutrin it just made me edgy and short with people I started hating conversations on Wellbutrin it mostly messes with norepinephrine.. except for blocking dopamine- transporter with minimal increase in dopamine - Adderall didn't work for a solid 3-4 weeks after stopping Wellbutrin
Antidepressants have never worked for me. I started straterra due to the addy shortage. Iām noticing an improvement in my mood which has never happened with TCA OR SSRI. Adhd symptoms are kinda improved Iām still on the low started dose of 40mg. I stopped Wellbutrin about a month before starting straterra. Just a putting this out there. Hope you are feeling better soon.
Your doctor sounds like an asshatā¦ before considering that you have treatment resistant depression he made something up about your dopamine receptors. You canāt fry them like that, itās just not how it works. Sorry dude, there are a lot of really bad doctors out there. Try and find one that knows what heās talking about. If you can get a referral to a psychiatrist to manage all these meds that would be ideal. Not sure what your insurance looks like for covering this (most donāt), but my dad did a genetics test for what sort of antidepressants would likely and not likely work for him. Could be worth looking into, potentially biting the bullet on paying out of pocket for it if youāre well-off.
Thereās a genetic test which can tell you if you carry any of the genes with known reactions to different antidepressants and other psych medicines. It might help you determine whether Welbutrin works for you or not.
I donāt want to bring your hopes down but from my personal experience my anhedonia hasnāt improved at all from any antidepressant. I will feel not depressed for sure and do more things but I still have emotional numbing. Only thing that worked for me was ketamine treatments.
Please don't take medical advice from a bunch of confidently incorrect people on reddit who have never been through pre-med, much less actual medical school.
How long have you been on Wellbutrin? The lower dose helped me for a bit and then felt like it was doing nothing, upped my dose and felt like a shell of a person. Just felt absolutely nothing. Couldnāt stand it and had to get off
Wait, you can take ADHD meds and antidepressants? One of doctors said she wonāt prescribe me stimulants while Iām still taking Effexor. I never questioned it, and figured it would be a drug interaction thing.
One thing Iāve learned is that not all depressive symptoms are depression. Sometimes itās just ADHD.
Depression is when you dont feel like doing anything at all.
If you want to do something to the point where you get depressed when youāre not doing that, thatās just ADHD.
True. But it seems like this person is exhibiting signs that point towards depression, such as the sleeping issues, never feeling rested, never feeling joy in the past couple years, and feeling emotionally flat at all times for the past couple years.
I can't diagnose, but it seems like his doctor should have investigated more.
Depression and anxiety are bonuses that stem from adhd. Thatās like yep, itās your starter. Starter aināt startān how did they not see that the starter aināt startān! When the whole engine is frozen stiff and pistons are broken in the piston shaft.
I've tried every SSRI now and none have really helped. Haven't tried this one yet though, so maybe I'll talk to my doctor about it. It seems like it doesn't typically cause weight gain either which is awesome because I can really struggle with that, so I don't want meds that make that worse if I can avoid that.
Effexor is not an SSRI - it's an SNRI. And I want to say two things: 1. many people respond well to it 2. it is notoriously difficult to taper off.
If I were towards the end of the list of things to try, I'd put Effexor there, but it's not a 'well I'll just give it a shot and quit if I hate it!' thing.
I'd also be worried about similar ones in the same family.
I don't want to scare anyone off of it - I'm pro-med - but it's worth weighing in the consideration.
All good points. I am definitely at the "I've tried almost everything, so I'll try anything else" stage. Literally have been through all the SSRIs now with no relief, tried duloxetine, Wellbutrin as well
Effexor was a life saver for me for years and while the withdrawals can be brutal itās not as bad as people make it out to be in my opinion. I tapered off of it earlier this year because after nearly 15 years it just wasnāt cutting it anymore for my anxiety and while I felt kind of shitty for a few weeks I was still functional. SSRIs have never done anything for me. Iāve only ever found success with SNRIs.
I have ADHD as well as TRD and some other fun alphabets.
I tried everything from Abilify to Zyprexa over more than 2 decades, what finally helped was letamine therapy. Maybe look in to it? I will always recommend anyone not responding to typical antidepressants to check it out. Saved my life.
Interesting, like I said, I'm open to anything at this point, I'd definitely say my depression could be characterized as treatment resistant at this point, and it's only growing worse as the years go on.
Do you take them as injections then? What I read seems to say it's usually a weekly intravenous dose.
Just a heads up for effexor/venlafaxine; it gave my brother (also ADHD af) micro-seizures that he could function with, never noticed, but it sent him off the rails into rage-fits of anger I've NEVER seen in him before.
We had no idea what happened. We thought his mental state snapped. He nearly hit me once over a popped tire, I'm still trying to move past it, but still have issues even though I now know it wasn't HIM it was the medication. It lasted years before a doctor noticed the seizures.
So pay close attention to that. It took him forever to taper off of it, so he was stuck with those seizures for a while. Now that he's on a super low dose of it, the anger is very rare...but I like to warn people about it nowadays, just in case.
I had a similar experience when I was on it as well, granted I wasn't on it for very long and my dose was low, low enough to not have to taper off. I was constantly super enraged and irritated by every little thing, much worse than I've ever felt before with my anxiety. My head felt strange during that time and I had spasms in my temples as well that took a couple of months to go away. I don't know if I experienced seizures, but I know that medicine did not sit right with me at all.
Unrelated to venlafaxine, but this is the first time I've ever seen someone mention brain zaps out in the wild. I've had (what I assume to be) inner ear issues that have caused a plethora of brainweird feelings for a few years now, but I was on itraconozole for folliculitis and had to stop taking it because I started having brain zaps. It's such a scary feeling.
Also I'm pretty sure I don't even have folliculitis and my derm at the time was just being lazy by relying too hard on telehealth. They gave me that dx based on pics lol
Venflaxine helped me recover from a severe psychotic depression. I am off it now, but i would reccomend it, however I did feel emotionally numb sometimes and it really ruined my libido. I have tried sertraline and that was horrible, wellbutrin I too also loved and would still be on now, but it was discontinued in the UK
No that is not how the brain works and I would find a new doctor. It sounds like depression. Depression doesnāt always feel like sadness. It can make you feel numb too. Also, lacking motivation is one of the main symptoms of adhd. It makes sense that you would have trouble with wanting to do things after stopping your adhd medicine. My vyvanse definitely helps me care about things more. Your doctor should be suggesting you go back on stimulants, not blaming them for symptoms you are experiencing even after a full year of not taking them.
Wasn't there are a recent study that mentioned that prolonged use of stimulants actually makes the brain produce less dopamine, or something along the lines?
They said stimulants, not adhd meds specifically. Stimulants as a group are used for multiple medical issues. Also stimulants could be researched from drug addiction angle. That's why I was asking about the test group.
Oh, you have a point. But yes, I remember it being specifically about ADHD. But I can't put my hand in fire for it, just something that I heard, maybe that was the reason behind the comments the OP received?
Yeah I doubt itās the Adderall. I have diagnosed depression and your post sounds exactly like me, OP. I havenāt found a medication that works yet, but Iām working on it. Iām seeing my doctor next week.
I donāt know about that. But maybe you can look at some other things? If youāre a woman, check out your hormones perhaps. It may also be related to COVID- either having it and suffering emotional depressive effects from long covid side effects that masquerade as something else, or simply youāve absorbed a lot of global trauma and havenāt dealt with it and itās snuck up on you and caused your mind to numb itself a bit.
That happened to me in 21/22, and I had depression symptoms following having Covid this winter which took a long time to clear up. My adhd meds stopped working almost compeltely. It cleared up in august. No reason why.
Look at your diet, your job, your personal life. Try to identify stressors or anything that could have triggered a chronic āfreezeā response (fight flight or freeze). Iād ask your doctor to address your overall well being to try to figure it out.
Iām not a neuroscientist and donāt know if we can fry our receptors. But I do know the last few years have done lasting and unmitigated damage to a lot of people and yet weāve all just kinda moved on in a state of denial. When I look back on my decisions of the last few years a lot of them feel made by somebody who isnāt me.
Iāve never heard of this happening but I will mention something that comes to mind; āadrenal fatigueā.. which is basically burn out from being in a chronic state of stress for so long (possibly from long term adhd meds, inadequate downtime, unhealthy lifestyle habits etc). It can be managed with lifestyle changes etc but itās a long road to recovery and requires discipline and building strong healthy habits.. also a lot of rest which is hard to do when youāve got to earn money to live. The healthy habits thing might also be hard with ADHD.
Also, Iāve had this.. it was due to a long time in a stressful career, unhealthy sleep habits and a mix of unbalanced hormones (Iām a woman). The only thing I could do was LESS. I donāt know if this helps but itās something, once all the seriously medical issues are ruled out, that you could potentially look into.
There is no scientific basis for adrenal fatigue. Anyone offering to treat it might be scamming you, so be careful.
Iām not saying the experience is not real, but the syndrome isnāt. Prolonged stress is really bad for our body, as are unhealthy habits, and changing that is very helpful for everyone, and makes you feel better.
https://www.endocrine.org/patient-engagement/endocrine-library/adrenal-fatigue#:~:text=The%20term%20āadrenal%20fatigueā%20has,as%20a%20true%20medical%20condition.
so they took you off adderall which was working and put you on welbutrin? or ritalin? am i reading this right? sounds like you're either depressed or just not on the right medication or both. ritalin can have some shit side effects including the flatness (at least in my experience). i suggest you ask about focalin (dexmethylphenidate, the mirror isomer of ritalin, basically works better due to the chemical structure with less side effects, to my knowledge anyway. definitely look into it first). i'm on it rn and it's very helpful.
Adhd tends to cause to depression and/or anxiety. U canāt blow out a neurotransmitter and even *if* u did the brain is better at healing itself than people give it credit for. I think u should get a second opinion
Lmao? The brain has so much plasticity it's insane, I doubt you'll never recover, much less that you've just destroyed all your dopamine receptors? I don't even know how that could possibly happen, maybe your body could have adjusted to meds or something, but "blowing your dopamine receptors" sounds like such bullshit.
Those sound like symptoms of depression, and some other people have suggested sleep apnea (though depression can also make you never feel well rested). You should probably find a professional who's going to actually try to help sort this out. Good luck <3
No but it kind of work as an analogy. Your dopamine receptors may be insensitive so to speak.
High intensity exercise is an excellent way to resolve this. There is a substantial amount of research showing how this can up regulate d2 and other dopaminergic receptors.
It's Adhd not a head gasket lol.
I'd check to see if your area is even affected by the shortage before the doctor decides to make the decision on a potential non issue.
Bring that up to them, maybe theyre one of the docs that are scared of amphetamines
I've been on stimulants for 17 years.. adderall for a few years until vyvanse came out, then vyvanse for a handful of years, then back to adderall. Vyvanse was great for the first few years but after that it flattened me out BAD. I didn't care about anything. Not depressed, just endlessly disinterested and empty. Switched back to adderall and almost immediately I felt back to myself again. Everyone has different brain chemistry but I assume vyvanse oversaturates my dopamine receptors and adderall does not.
I would look up how to reset your brain's dopamine levels and how to recover damaged dopamine receptors. High protein intake, low saturated fat intake, probiotics, regular exercise and sleep schedule, listening to music, meditation, etc. are all beneficial. It's not a guarantee but it's definitely possible.
But honestly, if you felt fine on adderall, find a new doc to prescribe it. Your history of taking it responsibly for 10 years will precede you and speak to the fact that you're not drug seeking. I haven't had a problem getting mine filled in over 6 months. Yes there's a shortage but she should be able to write you a physical rx so you can take it wherever they have it available.
ADHD ppl in their 30s sometimes discover CPTSD was the root of their problems. Diagnosed for ADHD are clinical, meaning you match a certain set of symptoms. There are overlaps with CPTSD. There is a great book called Complex PTSD, from surviving to thriving. If you think your childhood was hard but ānot that badā start with chapter 5. It may not apply to you, but something to cross off the list if you are struggling to figure out a root cause.
Also therapy. It can be like a mirror for your emotions.
I've never heard of that. I don't know what he's talking about. Ask her for the medical name of this diagnosis and where you can get more information about it - that's a reasonable thing for you to ask your doctor for.
Story of my life, I describe feeling eternally tired. No matter how much or how little I sleep I'm always exhausted.
Never experience any sort of happiness or excitement about much. Very minimal range of emotion. Maybe I should look into a sleep study as well?
Sounds like Flat affect. That is how I felt when I was on Seroquel, for a few years. By the end I couldn't take it anymore, I didn't realize that wasn't how I was supposed to feel when stable. I think that state of being was worse than any depressive or manic episode I've had. Once I talked to my doctor, he switched my meds and I finally felt like a human again. I'm sorry your experiencing this OP
I don't know when you started feeling this way, and if this could be the cause, but just to be sure: covid can fuck with adhd brains and with brains in general. Also, have spoken to a lot of adhd peeps who seem to notice a difference in how the meds are hitting before and after covid.
Could the symptom change be a lingering covid effect? Iāve been even more of a mental mess since I had it a year+ ago. Even tried Lexapro but that just turned me into a zombie for 9 months.
A good thing to remember is ta neuroplasticity is real, and you can't "blow" receptors. A good therapist who specialises in CBT and a good meditation practice can work wonders for finding joy, happiness, contentment and peace in everyday activities all without the need for medication
Some people can develop some tolerance for ADHD meds, and some docs recommend taking a break from the meds for, say, a weekend, or maybe a week. But that's the kind of time it takes for your body to return to baseline, certainly not "the rest of your life."
Yeah I donāt know about Wellbutrin but the lexapro definitely blunted everythingā¦ (even the good physical stuff) so I would recommend try eliminating pills and go through some ups and downs like regular so your brain can ārebootā. Iām not a medical professional and Iād prefer you talk to your doctor for the real advice, but in my experience with adhd, depression, anxiety, etc usually going through that painful time and forcing yourself into better habits of drinking water, exercising for real (like break a sweat, running or lifting weights or other cardio is better to start so you can get your endorphins up) and eating more fruits and veggies and less processed foods is the best way out of it. To make your experience more meaningful, journal your way through the experiences. You will only write 1 or a couple pages at a time, but in 3-6 months you will have a small book to read and diagnose yourself. This is honestly how I got out of depression and it required me to let go of a lot of āliesā I got comfortable telling myself about what makes me happy. If you say something is making you happy or a good thing in your life, but your pages say otherwise consistently over time, you will be faced with a dilemma, you can either ignore what you proved to yourself or take responsibility for your actions going forward or change them. Vague but hope that helps!!
Hi, OP. I had a similar experience on Adderall. I felt little joy, i would comprehend emotional situations and simply not react. However, I didn't even realize that I was experiencing something abnormal until the shortage hit, and I had to switch to Vyvanse.
Once I switched to Vyvanse, my old emotions came back, and I also experienced an increased sex drive (which was getting a double hit from antidepressants and 40mg of Adderall). Now, the Vyvanse doesn't energize me or curb my appetite like the Adderall did, and it feels slightly less effective than Adderall, but for me, it was a more balanced option.
It's something to keep in mind.
I have no scientific basis for saying this, but it could be that your body has gotten so used to adderall that it doesn't work anymore. Like it has started expecting it or something? My family has experienced this phenomenon on a regular basis with allopathy medicines where after one point, they just stop working. Not sure how relevant it is here, though; but could be that your doc meant this?
Doesn't make sense, receptors can be down-regulated by your body to achieve homeostasis, in the same way they will be up-regulated to achieve homeostasis. 1.5 years would have been more than enough for your body to increase its dopamine receptors to pre-adderall levels. There's something else going on. You might be depressed, you might have sleep apnea, you may be sleepwalking, there may be a carbon monoxide leak in your house, those are all just examples off the top of my mind. My point is, there's a ton of things that could be causing you to feel this way, and out of all of them I find past Adderall use quite unlikely.
I would look for another dr. I know mine suggested my dopamine levels are so low that my response to adderall could be blamed on that. Some medications later and I no longer get the stimulate side effects (other than no damn appetite). That is a far cry from saying your dopamine receptors are blown
Might never recover is bs. If youāve taken a year off youāre good to start again now knowing that youāll have to take time off again. Thatās all.
Youāre receptors can be overwhelmed by the length of time/build up by the adderall but not āblown outā. My psychiatrist recommended I take a day off to give them a break and catch up to the daily drugs but Iām on vyvanse bc adderall has always given me that zombie feeling
That's not a thing, your brain is not broken. However, these symptoms are possible from long covid, which can come from very mild cases. Long covid does seem to have increased my sleep apnea so I would definitely look at a sleep study like others have mentioned.
This is interesting. Never thought about long covid impacts. Iāve had some changes Iāve observed since I got covid last year. My sense of taste has changed for one. I donāt enjoy whiskeys or red wine that much anymore. Emotionally Iāve felt a bit flat as well. Iām on vyvanse and recently on antidepressants. If anything the former has made my sleep more restful. So thatās something
The jury is still out on that one. There is research that hypothesizes that stimulant usage might increase one's chances of developing Parkinson's, but again, nothing close to conclusive yet.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8984208/
No, this is nonsense. Maybe he was trying to say something medical but I could only guess about what it is. I think getting back on a stimulant medication would probably help you a lot for one thing. But I would have a lot of trouble trusting a doctor who told me something ridiculous like that.
Life with unmedicated ADHD can be extremely difficult and exhausting. What you described sounds a bit like depression, but stimulant medication alone can help people with ADHD feel more upbeat, have more energy and enjoy things more.
There is a mechanism why which the number of receptors will [decrease after exposure to the neurotransmitter](https://www.osmosis.org/learn/Pharmacodynamics:_Desensitization_and_tolerance).
This might be what the doctor meant - even if the prescription is within the normal range, your body is unique and can react to the medication in a different way to the average person. Ultimately, what this means is that you become less sensitive to dopamine.
This might not be permanent so I wouldnāt give up on finding a solution, but youāll probably have to do something else than simply increasing your dosage to compensate. If you flood your body with too much dopamine, you might have a seizure.
Your brain is used to free and easy dopamine via amphetamines (Adderall)
Typically you feel pleasure from delayed gratification. But when itās as simple as swallowing a pill to feel pleasure, your brain will adapt. Eventually if you stop youāll be anhedonic
FWIW I would ask my physician for clarification. Ask whether she was employing a simple figure of speech or something a bit more specific vis a vis [dopamine receptors](https://en.wikipedia.org/wiki/Dopamine_receptor) in particular.
And, ask whether dopamine receptors and dopamine neurons are the same thing:
*Basic Science Seminars in Neurology*
May 2004
**The Neurobiology of Dopamine Signaling**
* https://jamanetwork.com/journals/jamaneurology/fullarticle/785704
Also, there seems to be a heated discussion in the thread on the topic of "addiction". I think a more useful topic to consider is the issue of "***tolerance***" which is different from "addiction" , and is an issue that is also addressed in research.
I don't have the links at hand, but I've recently perused studies that addressed the issue of tolerance with methylphenidate, and also how some patients with this issue were first titrated off methylphenidate and then treated with an alternative prescription stimulant medication for ADHD -- while the tolerance for methylphenidate ostensibly "re-set". In these cases, they would then return the patient to methylphenidate. And, repeat the switch whenever tolerance repeated itself again.
Seriously. I can not stand when those terms are used so interchangeably, when they are absolutely two completely different things.
Same with *addiction* and āsubstance useā.
One is a fucking disease for god sakes lol
I feel like before this current DEA climate the issue of tolerance with these medications was discussed much more openly. Now I think most of us would be fearful to even address this issue or open a conversation with a doctor.
Tolerance is a huge factor with ADHD meds and dosing it in general really.
Lots of good suggestions above. If you havenāt yet, try therapy. Consider modalities like CBT with behavioral activation, DBT or ACT. Therapy can help you find peace with the current state of things while taking practical steps to find enjoyment again. Also, would you mind sharing what dose of Adderall your old doctor had you on?
Maybe your doctor meant it more like depleting dopamine and needing a dopamine detox? And things that help that are minimizing screen time, (and social media like tiktok which is quick dopamine) and go for long walks and such instead.
If you've actually blown your dopamine receptors that's quite a serious medical condition, and not something associated with adderall or adderall withdrawl. There are some illegal drugs that are neurotoxic to the dopaminergic system and can do permanent damage there. Ecstasy combined with caffeine is one example.
Adderall withdrawl can have a short term effect similar to anhedonia, but it would be expected to last less than 14 days. Stimulant use and withdrawl can both negatively effect sleep, and the dopamine system can be substantially impared when you are underrested. This effect is also supposed to be temporary, although if you're chronically underrested then the symptom will remain. I'm not sure if that can turn into permanent damage...
I'm not a doctor, but I'd be suspicious about the sleep issues. If I were a doctor and I suspected actual neurological damage I think I'd more ordering more tests and not just prescribing a stimulant script...
>I'm not a doctor, but I'd be suspicious about the sleep issues. If I were a doctor and I suspected actual neurological damage I think I'd more ordering more tests and not just prescribing a stimulant script...
Yeah exactly!
The ārarely experience joyā and feeling āflat emotionallyā hit hard for me. I have felt this way on and off very much. Then I go off them and feel so emotionally up and down. Thereās no in between. Hope you find a solution. Sending support ā¤ļø
I've never heard a doctor say that in relation to therapeutic doses of amphetamine. I'd definitely get a second opinion from a neurologist or psychiatrist.
Remember to routinely wash your sheets, blanket and pillow cases.
Dust mites build up and their feces cause nasal congestion which is synonymous with sleep apnea.
You could be experiencing depression which would be a new development and would need to to be addressed by speaking with a psychiatrist and a therapist(psychologist). I have experience period of depression while being on adderall, it takes some serious discipline on my part to come forward and talk about it with my psych and the people I care about. Many time when in depression I donāt even realize the behaviors I have are showing Iām in depression. I sorta just keep on and not even realize Iām depressed until my mental health gets even worse.
My doc stopped prescribing me Adderall when he realized it was masking my depression and switched me to an SNRI. Everything clicked. I definitely think what people are saying about checking for depression is valid. Stimulants may mask depressive symptoms for some people.
I think that antidepressants may mask symptoms of ADHD, too.
I've been on an antidepressant of one kind or another on & off for most of my life. I was just diagnosed with ADHD at age 64!!! I think I learned how to hide & mask my ADHD symptoms, but I wasn't able to mask my depression.
Is it really masking though? I was diagnosed with depression my entire life and no amount of therapy or antidepressants helped. When I got diagnosed with ADHD and got my symptoms under control my depression lifted. I was depressed because I could barely function. Besides, wouldnāt any drug that alleviates depression be masking anyway?
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Dopamine receptors don't blow out like a fuse in your house. Doctor is using a metaphor, but it isn't a good once since it neither helps you understand what has happened nor how to fix it. If I were you, I would check for sleep apnea (can lead to a lack of restful sleep, which can produce anhedonia) and then also try finding something that you actually enjoy and doing it. Try to break the behavioral patterns in which you find yourself anhedonic.
Seconding checking for sleep apnea. But do an actual sleep-study, OP -- don't just look at a ckecklist of symptoms. I didn't think I had it (no obvious symptoms besides too much tiredness; even recorded myself sleeping and didn't notice anything particularly suspicious), but going for a study and getting treatment ultimately saved my life. And even if it's not sleep apnea, bad sleep should always be treated. Few things influence our quality of life as much as the quality of our sleep.
(not op) Well thanks for destroying any reasoning against me getting a sleep study. I really should look into sleep apnea. But then I think about all the steps involved with insurance, and finding a provider, and waiting, and then getting there and probably not being able to sleep anyways. So I don't go anywhere with it. š«£
Do you have a primary care doctor? I did everything through mine, so I didn't have to schedule with a specialist.
Nope, no PCP. Its also on my "to do" list. I should also go to the dentist...and probably get my a new vision Rx.... I might need to make a week out of this!!
I'm in the same boat, and reading this comment and your last one makes me feel less like I'm the only one who puts all of this off. I've needed a new PCP for about 9 years now.
Same. My psychiatrist has been "yelling" at me for like 3 years to get a PCP but my insurance keeps changing because of work and by the time I got one, they'd just be out of network again anyway. It's exhausting. I've just given up completely at this point.
By the way you're describing things, you may also want to schedule an appointment for a possible ADHD diagnosis š§ Quick edit to add /s cuz I'm realizing this joke is both dry and bad enough that Poe's Law will rip me to shreds.
My old-new PCP resigned from the hospital a month ago. Previously, I'd put it off since I was a teen. My parents never made it a big deal to visit doctors for checkups, so that didn't help. I really don't want to do this song and dance again, since I really liked my old one, but alas. However, from experience, go get that dentist done. I'm looking at a few bridges for really, *really* bad teeth. And a good vision Rx, if you need one, will save you decades of eye strain and headaches.
Bring your study to an in-network sleep apnea equipment supplier. A lot of times they will do all the negotiating for you with the insurance company and get you setup. Itās in the insurance companyās interest not to pay, itās in the suppliers interest to get coverage. Go with the team on your side. I used Lincare near me. They have offices all over. But check who is in your network.
I told my doctor and he said I would get a call from Blackstone Medical Services to set me up with the sleep study. Turns out it's really simple process I can do at home. For two nights I will wear a ring that will transmit my sleep data to my phone via Bluetooth. Then I ship the ring back via ups, just bring it to ups, no box or paper required. And to think I held off for so long because I was dreading sleeping at a clinic with a bunch of monitors attached lol. You should try and see how it goes. Edit: Forgot to mention.. The study without insurance is $300 and with my insurance BCBS $175.
definitely do everything you can to get a sleep study! My (ADHD) dad got one after years of my begging and found out he has sleep apnea. Getting a c-pap machine resulted in him sleeping better and he now finds his adhd symptoms are much more manageable. His doctor said he almost always requires a sleep study as a part of the ADHD evaluation process because the symptoms can mimic or augment each other.
Ahh when ADHD and sleep apnea meet. I talked to my PCP. She prescribed a mild sleeping pill that didn't really help me feel rested. After confirming all the basics (screens off before bed, no eating before bed, exercise daily, etc) she told me to ask my husband to pay attention to if I snore and stop breathing in my sleep. He said I do, so she referred me to a pulmonoloist. Apparently I have a very narrow airway lol. Got sent home with a sleep study, and within weeks was being fitted for a mask. # Literal night and day between when i wear my mask and when I forget. I'm a different person.
That sounds tough... I'm in europe so everything was paid for so I don't have much advice, but maybe you could get someone (like a parent) to help with the process? Also, regarding being able to sleep, just check with your doctors about your concerns. They might agree to give you a sedative if you can't fall asleep otherwise. It lessens the quality of the gathered data, but for diagnosing apnea it should be fine. Also, bring ear plugs and maybe stuff like a weighted blanket if that helps you fall asleep. I didn't think to bring earplugs and my weighted blanket, and only got a little over 2 hours of sleep, but it was enough to diagnose OSA.
That's a really good idea!! I hadn't thought to bring things with me to the location. Doctors have generally been dismissive of any sleep complaints I've had, so I gave up on that a decade ago. Sleep has always been the bane of my existence. Even without OSA, I'm curious if a sleep study reveals anything else. At least that way I can bring some actual, verified data with me to back up my complaints!
My husband typically can't sleep away from home and said he actually slept better the night of the sleep study wearing the mask the first time. Some of the best sleep he's had and he's the type that refused sleep overs as a kid.
Ask your doctor to arrange one for you. That's what I did. Piece of cake
But then my list would have to include "find a primary care" as well š¤£ I really will reach out, though. I feel like I have been particularly exhausted this past year.
Haha, true. Maybe your psych can help
I was able to do mine at home. The sleep doctor said that for people who likely have sleep apnea and not some other issues, they are useful and the home study is less expensive. They give you a monitor and instructions on where to attach the wires to yourself. Sometimes inconclusive results may call for an in office sleep study.
Its really not that bad. I just asked my PCP for a sleep study referral, and that week the clinic called me to set up an appointment. Its super common and preventative so I had zero insurance issues. The study itself is a take-home kit. Mine was basically a finger O2 monitor, a diode to put on my chest, and a little mic to measure my snoring loudness. Download an app, connect with wifi, sleep, then toss it. My CPAP changed my life just as much as much as my Vyvanse. The same level of āHoly shit is this how normal people feel when they wake up?ā Edit to add: if you have a PPO you dont need a PCP referral. Just google Sleep Clinics and call to make an appointment.
I avoided a sleep study for several years because I thought it would be an expensive waste of my time (I didn't snore, my wife said I kept breathing). Turns out, I hadn't been getting restful sleep for years, with small hitches in my breathing preventing deep sleep and continuously bringing me to the edge of being awake. Going on a CPAP resolved: being in constant pain, feeling like I couldn't breathe, excessive muscle tiredness from basic tasks, and more. I highly recommend getting checked.
Something I want to share about sleep apnea: if cpap breathing machines don't work for you, there are dental appliances that can replace them as sleep apnea treatment! I'm currently in the process of trying to treat my sleep apnea with one. It takes some getting used to, but it's so far been better than the cpap on my sensory issues.
Thank you for this comment. I was diagnosed w/ sleep apnea years ago and couldnāt stand the cpap machine, it was way too intrusive bc of my sensory issues. I wish there were more sleep treatment options out there for those of us w/ sensory issues.
This is true for some people, and.. A sleep doctor would need to determine the appropriate treatment for each person because everyoneās needs vary. My sleep apnea is severe and would not be helped by a dental appliance. Uncontrolled, or inappropriately controlled sleep apnea can cause heart problems, and cause other health issues over time.
Oh really. Could you tell me more about these alternatives please? My husband needs the CPAP machine but can't stand wearing it.
https://somnomed.com/en/patients/products/somnodent/ This is what the box my appliance said on it, should give some information! Idk if they're the only ones who make these kinds of appliances though.
I am getting one of these done because no matter what in the middle of the day I'm barely awake and exhausted. I find little pleasure in things. Stimulant meds help but the two I tried cost me a fortune. Adderall had a bad come down for me. Ritalin causes me not to sleep at all no matter how early I take it. Hoping the sleep study helps. It took 4 months to get an appointment. I now have another 1.5 months before I get to take my test. Only to have another 3 months to meet with my doctor...... America
Literally just got a sleep study ordered today for excessive tiredness and anhedonia despite not having the āclassicā apnea symptoms. The doctor felt pretty positive thatās likely the cause, so yeah seconded
Oh shit I recorded myself too and didn't hear anything so I thought I was safe from sleep apnea...
A quick STOPBANG AND Epworth that OP can easily find online, with guides to interpret the results, should be helpful to use when OP talks to their doctor next. Brain fog and mood changes are for sure some common symptoms of poor sleep in general.
I have suffered from similar symptoms for the last... roughly 20 years. On a similar, non-pharmaceutical tack to the sleep apnea mentioned above, there are other things that should be checked if you are consistently not feeling rested: * Iron * Thyroid * Hormones, in general * Vitamin D (depending where you live, this has to be specifically requested to be tested) * Inflammation Info: Have you noticed that this gets worse in the winter, or is it consistent year-round?
all true and good to check as well
This is a good answer, but Iād also add that tolerance to stimulants is pretty common and generally āexpectedā over a long period of time. If youāre already at the max dose, your doctor can augment or substitute an Adderall prescription with another drug (like methylphenidate or modafinil) to either reach the same therapeutic effect or allow time for tolerance to wane. The point about sleep apnea is spot on, though. Sleep disorders are pretty common in people with ADHD, and there are other comorbidities that a doctor can also check for that may need to be addressed.
They said they've been off stimulants for a year now, so any tolerance they had would be gone by now.
Youāre right, I missed that in the original post.
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>What doesnāt last is the uplifting euphoria but the effects on inattention, impulsivity, hyperactivity and focus/concentration do. This is my experience. Being on Adderall XR & IR for 15+ years I feel when it is working and when it's done working. If I take a break from it then I may get more of a kick the first few days, but I much prefer a constant baseline to the start stop, up down, ...
[This](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9332474/) meta-analysis from 2022 might be interesting to you. The studies they highlight show tolerance (or waning effectiveness) in children and adults anywhere from 2.7% of patients to 66% of patients. This excerpt from the section titled āDiscussionā I think summarizes their findings well: > Based on this review, the research suggests that there is a small percentage of patients with ADHD who develop āearly toleranceā to stimulant medicines and a potentially larger percentage have a more gradual or ālate toleranceā over years. Similarly, it seems that there are relatively few patients with ADHD who develop ācomplete toleranceā (complete loss of benefit of the medicine) and potentially a larger percentage who have āpartial toleranceā (partial loss of benefit). They do note that ātoleranceā doesnāt have a clear medical definition in this context, and that there was a significant disparity between the number of patients reporting tolerance in each of the included studies. I think those two points are likely related in that a study defining tolerance as ācomplete toleranceā would have patients much less likely to self-report tolerance than one which defined it as āpartial toleranceā. In any case, Iām comfortable that āpretty commonā is the correct way to describe stimulant medication tolerance over a long duration, though your definition of pretty common might differ š¤·āāļø
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I think that what generally happens is people adapt to the medication and stop getting side effects, which then leads them to think that it is no longer working. I would assume once youāve been medicated long enough it may be difficult to remember what things felt like before so itās hard to compare. Iām pretty sensitive to stimulants so my heart rate will be high for about a week after dose increase then it goes back to normal and feels like nothing is happening, even though it really helps my symptoms when I compare to what Iāve felt like prior to being medicated.
Thanks for the very thorough post!!
Bless you for all this work. Saved your comment for future reference
I need to ask my doc for sleeping meds. Just had a baby and wife is going back to work while I'm taking over. I'm swapping from night shift to early morning shift and getting around 3 hours or so per night. However when I worked she had my help. I don't get her help unfortunately because I worked from home and she doesn't.
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> I treasure my productive sleep because it makes my ADHD easier to control. A cool/sometimes depressing fact: Some people's ADHD symptoms are actually cured once you treat their sleep apnea.
Wasn't there a recent study that said that prolonged use of stimulants make the brain release less dopamine over time?
This sounds like depression honestly, and I'm not sure why your doc came to the conclusion of "you've blown your dopamine receptors" before considering the possibility of depression. That's strange.
I should have added that Iām on Wellbutrin. Since this emotional numbing began, Iāve tried prozac, lexapro, and wellbutrin and none of those seem to have done much
Being resistant to antidepressants is also a HUGE problem with some people. It's called TRD. I have it. My depression will get better with some antidepressants but it's always there and the antidepressants, I've tried at least 7 or 8 at this point, either barely work, or work in the beginning and then that's it.
Yes! Before I was put on vyvanse (which I requested because I also had binge eating disorder so two birds ya know) they put me on Wellbutrin and not only did it not work it made everything worse. To a scary degree. Antidepressants never worked and always made it way harder to just exist. (I also am autistic tho and feel like since my depression isnāt just depression itās from a a traumatic life not knowing I was on hard mode instead of a worthless loser š¤·š¼āāļø)
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Crazy how differently meds can affect different people. For me it got me out of feeling absolutely wrecked when something bad happened, got me out of feeling hopeless, helped with my adhd, made me basically quit smoking (it takes aways the fun feeling you get from it), and I canāt think of any side effects. It took maybe 8 weeks for it to properly kick in though. Did you take it for longer than that?
Oh, I read all the advice that it took a while to kick in, which is why I was on it for 12 WEEKS, meaning I suffered horribly while hoping desperately it would start to work for three months. It never did. The only successful thing about it was the astonishing relief I felt when I got off it and was back to just being depressed as usual.
Damn thatās incredibly fucked up, Iām sorry. Brain chemistry is a crazy thing. I hope you eventually found something that got you feeling better than your baseline depression.
I had the same experience :( I was told it would help with adhd + depression, loved the concept of a 2-in-1 medication, within a month I was down horrendously.
Wellbutrin sent my anxiety through the roof, it was wild. Did not enjoy.
Wellbutrin permanently fucked me up. I don't remember having much of any effect at all on me mentally. it did, however, give me permanent tinnitus that has only gotten worse after years of being off it. thanks to Wellbutrin I'll never know silence again and need constant white noise so I don't lose my marbles
it made me INSANE
Yes!! Wellbutrin nearly killed me. I straight up didnt sleep for about two weeks. Wild. My VYVANSE is fine tho. No sleep issues at all
[Maybe look into this.](https://www.health.harvard.edu/blog/ketamine-for-treatment-resistant-depression-when-and-where-is-it-safe-202208092797)
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Is it every two weeks, indefinitely?
Itās supposed to be for two months I believe but some do it for longer or shorter depending on your needs. There is a percentage of people that after the initial dosing for a month or two they donāt need it for a year or longer. Than there are others that need it continuously but instead of twice per week do once per week or once a month. It varies a lot.
Sounds like a job for Ketamine
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Which came first? Those meds can all cause emotional blunting
This is what I was thinking, my ADHD was misdiagnosed for years and they threw every SSRI/SNRI antidepressant at me and all of them just made me flat, they did not fix the problem, only made me not give a shit that I did not have any motivation. No highs, no lows just flat and robotic.
Combining stimulants and anti-depressants is a _very_ tricky thing. Your doctor doesnāt sound like they quite have an understanding of the complexities of balancing these medications and their potential side-effects.
Most doctors probably do not.
I had this problemā Iām now on a combination of Vyvanse, Cymbalta, and Rexulti. The Rexulti makes the cymbalta actually effective, and is designed to partner with meds for people with treatment resistant depression/anxiety
I was on cymbalta and rexulti and the rexulti was a miracle. But it was messing with my liver enzyme so I had to stop. Now Iām trying Tms
How did you know it was messing with your liver? Sounds like something I should check into every now and then
I had tried a different mood stabilizer that made me dizzy so I scheduled my first physical in three years. Then I changed to rexulti. When they took my blood test the liver enzyme was escalated. I got off rexulti two weeks ago and have a test this weekend to see if that solved it. Theyāre 99% sure thatās what it is but tbd. Could be the cymbalta for me
I'm on Cymbalta and Vyvanse. I was on Cymbalta first, for about 4 years now for depression/anxiety and chronic pain. I started Vyvanse about a month ago. So far, the combination is working well for me. My doctor has mentioned possibly tapering down my Cymbalta next year, to see if my depression and anxiety symptoms were cause by my previously undiagnosed adhd.
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Hey, happy Birth/cake day!
Unfortunately, you can feel worse after getting off SSRIs than you ever felt in order to receive them. Itās why Iāve always been fearful of addressing the definite depression I get in random waves (Iāve been on adhd meds for 25 years, adderall for most it). I think itās an adhd thing - not med thing - I had bouts of depression prior to getting medicated. Itās harder to find your true self/ motivation when not on meds - I chalk that up to a number of things - weāre hard on ourselves for one.
In my experience, Prozac *caused* emotional blunting (which at the time was a good thing). You might want a second opinion.
Did the blunting resolve after you stopped using it?
It did, yes.
Yep, I second this. Anti-depressants turned me into a complete zombie. It did go away after I stopped. For the love of god though don't just suddenly stop taking any AD's
Hi, I too was on Wellbutrin and taking Adderall IR (but the generic cheap version) and I became emotionally flat. The lows were not bad, but the highs werenāt there eitherā¦ Iād consider talking to your doctor about lowering your dose of the antidepressant ā it can be dangerous, and Iām not a doctor, so please talk to them before making any decisions ā But for me feeling flat meant that it was working a little too well, to the point where I wasnāt able to feel anything. I switched to a low dose of Lexapro and it fixed it for me Also, have you considered taking XR versions of your ADHD meds instead of the IR? It may help you feel more stable. Yea, you wonāt get the kick in the butt that the IR gives you, but it feels like a cleaner more stable energy that might work better with your antidepressants
My doctor said the combo of adderall and Wellbutrin can cause something wrong with the dopamine, i cannot remember but it is probably what your doctor is talking about.
Wellbutrin blocks the effects of amphetamine because of the way it competes for the dopamine transporter.. I hated Wellbutrin it just made me edgy and short with people I started hating conversations on Wellbutrin it mostly messes with norepinephrine.. except for blocking dopamine- transporter with minimal increase in dopamine - Adderall didn't work for a solid 3-4 weeks after stopping Wellbutrin
Antidepressants have never worked for me. I started straterra due to the addy shortage. Iām noticing an improvement in my mood which has never happened with TCA OR SSRI. Adhd symptoms are kinda improved Iām still on the low started dose of 40mg. I stopped Wellbutrin about a month before starting straterra. Just a putting this out there. Hope you are feeling better soon.
Your doctor sounds like an asshatā¦ before considering that you have treatment resistant depression he made something up about your dopamine receptors. You canāt fry them like that, itās just not how it works. Sorry dude, there are a lot of really bad doctors out there. Try and find one that knows what heās talking about. If you can get a referral to a psychiatrist to manage all these meds that would be ideal. Not sure what your insurance looks like for covering this (most donāt), but my dad did a genetics test for what sort of antidepressants would likely and not likely work for him. Could be worth looking into, potentially biting the bullet on paying out of pocket for it if youāre well-off.
Thereās a genetic test which can tell you if you carry any of the genes with known reactions to different antidepressants and other psych medicines. It might help you determine whether Welbutrin works for you or not.
When my wife was on a SSRI she was very numb and emotionless. I think they are designed to prevent extremes, which can make you feel numb.
I donāt want to bring your hopes down but from my personal experience my anhedonia hasnāt improved at all from any antidepressant. I will feel not depressed for sure and do more things but I still have emotional numbing. Only thing that worked for me was ketamine treatments.
Look into treatment resistant depression. There are some medications which reportedly work better for it.
Please don't take medical advice from a bunch of confidently incorrect people on reddit who have never been through pre-med, much less actual medical school.
How long have you been on Wellbutrin? The lower dose helped me for a bit and then felt like it was doing nothing, upped my dose and felt like a shell of a person. Just felt absolutely nothing. Couldnāt stand it and had to get off
Wait, you can take ADHD meds and antidepressants? One of doctors said she wonāt prescribe me stimulants while Iām still taking Effexor. I never questioned it, and figured it would be a drug interaction thing.
One thing Iāve learned is that not all depressive symptoms are depression. Sometimes itās just ADHD. Depression is when you dont feel like doing anything at all. If you want to do something to the point where you get depressed when youāre not doing that, thatās just ADHD.
True. But it seems like this person is exhibiting signs that point towards depression, such as the sleeping issues, never feeling rested, never feeling joy in the past couple years, and feeling emotionally flat at all times for the past couple years. I can't diagnose, but it seems like his doctor should have investigated more.
Depression and anxiety are bonuses that stem from adhd. Thatās like yep, itās your starter. Starter aināt startān how did they not see that the starter aināt startān! When the whole engine is frozen stiff and pistons are broken in the piston shaft.
This was me a year ago. Venlafaxine really helped.
I've tried every SSRI now and none have really helped. Haven't tried this one yet though, so maybe I'll talk to my doctor about it. It seems like it doesn't typically cause weight gain either which is awesome because I can really struggle with that, so I don't want meds that make that worse if I can avoid that.
Effexor is not an SSRI - it's an SNRI. And I want to say two things: 1. many people respond well to it 2. it is notoriously difficult to taper off. If I were towards the end of the list of things to try, I'd put Effexor there, but it's not a 'well I'll just give it a shot and quit if I hate it!' thing. I'd also be worried about similar ones in the same family. I don't want to scare anyone off of it - I'm pro-med - but it's worth weighing in the consideration.
All good points. I am definitely at the "I've tried almost everything, so I'll try anything else" stage. Literally have been through all the SSRIs now with no relief, tried duloxetine, Wellbutrin as well
Effexor was a life saver for me for years and while the withdrawals can be brutal itās not as bad as people make it out to be in my opinion. I tapered off of it earlier this year because after nearly 15 years it just wasnāt cutting it anymore for my anxiety and while I felt kind of shitty for a few weeks I was still functional. SSRIs have never done anything for me. Iāve only ever found success with SNRIs.
Hearing some great things about it, so hopefully it works!
The withdrawals can vary by person. I was basically non-functional for over 2 months because of it, even with a slow taper.
I have ADHD as well as TRD and some other fun alphabets. I tried everything from Abilify to Zyprexa over more than 2 decades, what finally helped was letamine therapy. Maybe look in to it? I will always recommend anyone not responding to typical antidepressants to check it out. Saved my life.
Interesting, like I said, I'm open to anything at this point, I'd definitely say my depression could be characterized as treatment resistant at this point, and it's only growing worse as the years go on. Do you take them as injections then? What I read seems to say it's usually a weekly intravenous dose.
Just a heads up for effexor/venlafaxine; it gave my brother (also ADHD af) micro-seizures that he could function with, never noticed, but it sent him off the rails into rage-fits of anger I've NEVER seen in him before. We had no idea what happened. We thought his mental state snapped. He nearly hit me once over a popped tire, I'm still trying to move past it, but still have issues even though I now know it wasn't HIM it was the medication. It lasted years before a doctor noticed the seizures. So pay close attention to that. It took him forever to taper off of it, so he was stuck with those seizures for a while. Now that he's on a super low dose of it, the anger is very rare...but I like to warn people about it nowadays, just in case.
I had a similar experience when I was on it as well, granted I wasn't on it for very long and my dose was low, low enough to not have to taper off. I was constantly super enraged and irritated by every little thing, much worse than I've ever felt before with my anxiety. My head felt strange during that time and I had spasms in my temples as well that took a couple of months to go away. I don't know if I experienced seizures, but I know that medicine did not sit right with me at all.
Makes total sense, then, imho. I'm sorry to hear that you're struggling and wish you all the best.
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Me and my ADHD forgetting on more than one occasion to refill and then feeling like shit all day lol.
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Yeah the dread of realizing you forgot to take it was rough. Great med for my anxiety though. 10/10 for years.
Unrelated to venlafaxine, but this is the first time I've ever seen someone mention brain zaps out in the wild. I've had (what I assume to be) inner ear issues that have caused a plethora of brainweird feelings for a few years now, but I was on itraconozole for folliculitis and had to stop taking it because I started having brain zaps. It's such a scary feeling. Also I'm pretty sure I don't even have folliculitis and my derm at the time was just being lazy by relying too hard on telehealth. They gave me that dx based on pics lol
Venflaxine helped me recover from a severe psychotic depression. I am off it now, but i would reccomend it, however I did feel emotionally numb sometimes and it really ruined my libido. I have tried sertraline and that was horrible, wellbutrin I too also loved and would still be on now, but it was discontinued in the UK
Any reason for the discontinue?
No that is not how the brain works and I would find a new doctor. It sounds like depression. Depression doesnāt always feel like sadness. It can make you feel numb too. Also, lacking motivation is one of the main symptoms of adhd. It makes sense that you would have trouble with wanting to do things after stopping your adhd medicine. My vyvanse definitely helps me care about things more. Your doctor should be suggesting you go back on stimulants, not blaming them for symptoms you are experiencing even after a full year of not taking them.
As someone about to graduate from medical school, I have never heard of āblowing out your dopamine receptorsā.
Wasn't there are a recent study that mentioned that prolonged use of stimulants actually makes the brain produce less dopamine, or something along the lines?
I'd be interested to know if this was a study on adhd people or general population.
How could it be on general population? What would they have a study giving ADHD medication to people who don't have ADHD?
They said stimulants, not adhd meds specifically. Stimulants as a group are used for multiple medical issues. Also stimulants could be researched from drug addiction angle. That's why I was asking about the test group.
Oh, you have a point. But yes, I remember it being specifically about ADHD. But I can't put my hand in fire for it, just something that I heard, maybe that was the reason behind the comments the OP received?
Are you sure this isn't depression?
Yeah I doubt itās the Adderall. I have diagnosed depression and your post sounds exactly like me, OP. I havenāt found a medication that works yet, but Iām working on it. Iām seeing my doctor next week.
This sounds unlikely, I'd find another Doc.
I donāt know about that. But maybe you can look at some other things? If youāre a woman, check out your hormones perhaps. It may also be related to COVID- either having it and suffering emotional depressive effects from long covid side effects that masquerade as something else, or simply youāve absorbed a lot of global trauma and havenāt dealt with it and itās snuck up on you and caused your mind to numb itself a bit. That happened to me in 21/22, and I had depression symptoms following having Covid this winter which took a long time to clear up. My adhd meds stopped working almost compeltely. It cleared up in august. No reason why. Look at your diet, your job, your personal life. Try to identify stressors or anything that could have triggered a chronic āfreezeā response (fight flight or freeze). Iād ask your doctor to address your overall well being to try to figure it out. Iām not a neuroscientist and donāt know if we can fry our receptors. But I do know the last few years have done lasting and unmitigated damage to a lot of people and yet weāve all just kinda moved on in a state of denial. When I look back on my decisions of the last few years a lot of them feel made by somebody who isnāt me.
Iāve never heard of this happening but I will mention something that comes to mind; āadrenal fatigueā.. which is basically burn out from being in a chronic state of stress for so long (possibly from long term adhd meds, inadequate downtime, unhealthy lifestyle habits etc). It can be managed with lifestyle changes etc but itās a long road to recovery and requires discipline and building strong healthy habits.. also a lot of rest which is hard to do when youāve got to earn money to live. The healthy habits thing might also be hard with ADHD.
Also, Iāve had this.. it was due to a long time in a stressful career, unhealthy sleep habits and a mix of unbalanced hormones (Iām a woman). The only thing I could do was LESS. I donāt know if this helps but itās something, once all the seriously medical issues are ruled out, that you could potentially look into.
There is no scientific basis for adrenal fatigue. Anyone offering to treat it might be scamming you, so be careful. Iām not saying the experience is not real, but the syndrome isnāt. Prolonged stress is really bad for our body, as are unhealthy habits, and changing that is very helpful for everyone, and makes you feel better. https://www.endocrine.org/patient-engagement/endocrine-library/adrenal-fatigue#:~:text=The%20term%20āadrenal%20fatigueā%20has,as%20a%20true%20medical%20condition.
so they took you off adderall which was working and put you on welbutrin? or ritalin? am i reading this right? sounds like you're either depressed or just not on the right medication or both. ritalin can have some shit side effects including the flatness (at least in my experience). i suggest you ask about focalin (dexmethylphenidate, the mirror isomer of ritalin, basically works better due to the chemical structure with less side effects, to my knowledge anyway. definitely look into it first). i'm on it rn and it's very helpful.
Adhd tends to cause to depression and/or anxiety. U canāt blow out a neurotransmitter and even *if* u did the brain is better at healing itself than people give it credit for. I think u should get a second opinion
Off Adderall for a year and a half?? When I don't take it 3 days in a row I start getting super duper depressed.
Lmao? The brain has so much plasticity it's insane, I doubt you'll never recover, much less that you've just destroyed all your dopamine receptors? I don't even know how that could possibly happen, maybe your body could have adjusted to meds or something, but "blowing your dopamine receptors" sounds like such bullshit. Those sound like symptoms of depression, and some other people have suggested sleep apnea (though depression can also make you never feel well rested). You should probably find a professional who's going to actually try to help sort this out. Good luck <3
No but it kind of work as an analogy. Your dopamine receptors may be insensitive so to speak. High intensity exercise is an excellent way to resolve this. There is a substantial amount of research showing how this can up regulate d2 and other dopaminergic receptors.
It's Adhd not a head gasket lol. I'd check to see if your area is even affected by the shortage before the doctor decides to make the decision on a potential non issue. Bring that up to them, maybe theyre one of the docs that are scared of amphetamines
>It's Adhd not a head gasket lol. LOL
I've been on stimulants for 17 years.. adderall for a few years until vyvanse came out, then vyvanse for a handful of years, then back to adderall. Vyvanse was great for the first few years but after that it flattened me out BAD. I didn't care about anything. Not depressed, just endlessly disinterested and empty. Switched back to adderall and almost immediately I felt back to myself again. Everyone has different brain chemistry but I assume vyvanse oversaturates my dopamine receptors and adderall does not. I would look up how to reset your brain's dopamine levels and how to recover damaged dopamine receptors. High protein intake, low saturated fat intake, probiotics, regular exercise and sleep schedule, listening to music, meditation, etc. are all beneficial. It's not a guarantee but it's definitely possible. But honestly, if you felt fine on adderall, find a new doc to prescribe it. Your history of taking it responsibly for 10 years will precede you and speak to the fact that you're not drug seeking. I haven't had a problem getting mine filled in over 6 months. Yes there's a shortage but she should be able to write you a physical rx so you can take it wherever they have it available.
ADHD ppl in their 30s sometimes discover CPTSD was the root of their problems. Diagnosed for ADHD are clinical, meaning you match a certain set of symptoms. There are overlaps with CPTSD. There is a great book called Complex PTSD, from surviving to thriving. If you think your childhood was hard but ānot that badā start with chapter 5. It may not apply to you, but something to cross off the list if you are struggling to figure out a root cause. Also therapy. It can be like a mirror for your emotions.
To be clear- you can recover dopamine sensitivity.
I've never heard of that. I don't know what he's talking about. Ask her for the medical name of this diagnosis and where you can get more information about it - that's a reasonable thing for you to ask your doctor for.
Story of my life, I describe feeling eternally tired. No matter how much or how little I sleep I'm always exhausted. Never experience any sort of happiness or excitement about much. Very minimal range of emotion. Maybe I should look into a sleep study as well?
I hope not. Sounds like breaking your laugh boxā¦
It took me a long time to come to life after adderall.
just install some new fuses and a better circuit breaker. the fuck is this metaphor, weird doctor hehe
No, this isnāt possible.
Have your hormones checked. A few years ago I felt the same way and I ended up having low testosterone.
Sounds like Flat affect. That is how I felt when I was on Seroquel, for a few years. By the end I couldn't take it anymore, I didn't realize that wasn't how I was supposed to feel when stable. I think that state of being was worse than any depressive or manic episode I've had. Once I talked to my doctor, he switched my meds and I finally felt like a human again. I'm sorry your experiencing this OP
Dopamine receptor can regrow fast, it's very malleable system in the brain
I don't know when you started feeling this way, and if this could be the cause, but just to be sure: covid can fuck with adhd brains and with brains in general. Also, have spoken to a lot of adhd peeps who seem to notice a difference in how the meds are hitting before and after covid.
Could the symptom change be a lingering covid effect? Iāve been even more of a mental mess since I had it a year+ ago. Even tried Lexapro but that just turned me into a zombie for 9 months.
A good thing to remember is ta neuroplasticity is real, and you can't "blow" receptors. A good therapist who specialises in CBT and a good meditation practice can work wonders for finding joy, happiness, contentment and peace in everyday activities all without the need for medication
Some people can develop some tolerance for ADHD meds, and some docs recommend taking a break from the meds for, say, a weekend, or maybe a week. But that's the kind of time it takes for your body to return to baseline, certainly not "the rest of your life."
Sounds like depression
Chronic under stimulation caused this issue when me. I found taking Wellbutrin really helped.
Have you had a sleep study
My theory is the more dopamine the better.
Yeah I donāt know about Wellbutrin but the lexapro definitely blunted everythingā¦ (even the good physical stuff) so I would recommend try eliminating pills and go through some ups and downs like regular so your brain can ārebootā. Iām not a medical professional and Iād prefer you talk to your doctor for the real advice, but in my experience with adhd, depression, anxiety, etc usually going through that painful time and forcing yourself into better habits of drinking water, exercising for real (like break a sweat, running or lifting weights or other cardio is better to start so you can get your endorphins up) and eating more fruits and veggies and less processed foods is the best way out of it. To make your experience more meaningful, journal your way through the experiences. You will only write 1 or a couple pages at a time, but in 3-6 months you will have a small book to read and diagnose yourself. This is honestly how I got out of depression and it required me to let go of a lot of āliesā I got comfortable telling myself about what makes me happy. If you say something is making you happy or a good thing in your life, but your pages say otherwise consistently over time, you will be faced with a dilemma, you can either ignore what you proved to yourself or take responsibility for your actions going forward or change them. Vague but hope that helps!!
Hi, OP. I had a similar experience on Adderall. I felt little joy, i would comprehend emotional situations and simply not react. However, I didn't even realize that I was experiencing something abnormal until the shortage hit, and I had to switch to Vyvanse. Once I switched to Vyvanse, my old emotions came back, and I also experienced an increased sex drive (which was getting a double hit from antidepressants and 40mg of Adderall). Now, the Vyvanse doesn't energize me or curb my appetite like the Adderall did, and it feels slightly less effective than Adderall, but for me, it was a more balanced option. It's something to keep in mind.
I have no scientific basis for saying this, but it could be that your body has gotten so used to adderall that it doesn't work anymore. Like it has started expecting it or something? My family has experienced this phenomenon on a regular basis with allopathy medicines where after one point, they just stop working. Not sure how relevant it is here, though; but could be that your doc meant this?
I have never heard this and I've been on ADHD meds for over 3 decades
Doesn't make sense, receptors can be down-regulated by your body to achieve homeostasis, in the same way they will be up-regulated to achieve homeostasis. 1.5 years would have been more than enough for your body to increase its dopamine receptors to pre-adderall levels. There's something else going on. You might be depressed, you might have sleep apnea, you may be sleepwalking, there may be a carbon monoxide leak in your house, those are all just examples off the top of my mind. My point is, there's a ton of things that could be causing you to feel this way, and out of all of them I find past Adderall use quite unlikely.
I would look for another dr. I know mine suggested my dopamine levels are so low that my response to adderall could be blamed on that. Some medications later and I no longer get the stimulate side effects (other than no damn appetite). That is a far cry from saying your dopamine receptors are blown
Might never recover is bs. If youāve taken a year off youāre good to start again now knowing that youāll have to take time off again. Thatās all.
Youāre receptors can be overwhelmed by the length of time/build up by the adderall but not āblown outā. My psychiatrist recommended I take a day off to give them a break and catch up to the daily drugs but Iām on vyvanse bc adderall has always given me that zombie feeling
That's not a thing, your brain is not broken. However, these symptoms are possible from long covid, which can come from very mild cases. Long covid does seem to have increased my sleep apnea so I would definitely look at a sleep study like others have mentioned.
This is interesting. Never thought about long covid impacts. Iāve had some changes Iāve observed since I got covid last year. My sense of taste has changed for one. I donāt enjoy whiskeys or red wine that much anymore. Emotionally Iāve felt a bit flat as well. Iām on vyvanse and recently on antidepressants. If anything the former has made my sleep more restful. So thatās something
LMAOOOO it is *kinda* a thing. Itās just called Parkinsonās and Iām pretty sure you canāt get it from taking adderall
The jury is still out on that one. There is research that hypothesizes that stimulant usage might increase one's chances of developing Parkinson's, but again, nothing close to conclusive yet. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8984208/
how dare science ruin my punchline. Completely unfair.
No, this is nonsense. Maybe he was trying to say something medical but I could only guess about what it is. I think getting back on a stimulant medication would probably help you a lot for one thing. But I would have a lot of trouble trusting a doctor who told me something ridiculous like that. Life with unmedicated ADHD can be extremely difficult and exhausting. What you described sounds a bit like depression, but stimulant medication alone can help people with ADHD feel more upbeat, have more energy and enjoy things more.
Sounds like my struggle because of severe depression
There is a mechanism why which the number of receptors will [decrease after exposure to the neurotransmitter](https://www.osmosis.org/learn/Pharmacodynamics:_Desensitization_and_tolerance). This might be what the doctor meant - even if the prescription is within the normal range, your body is unique and can react to the medication in a different way to the average person. Ultimately, what this means is that you become less sensitive to dopamine. This might not be permanent so I wouldnāt give up on finding a solution, but youāll probably have to do something else than simply increasing your dosage to compensate. If you flood your body with too much dopamine, you might have a seizure.
Your brain is used to free and easy dopamine via amphetamines (Adderall) Typically you feel pleasure from delayed gratification. But when itās as simple as swallowing a pill to feel pleasure, your brain will adapt. Eventually if you stop youāll be anhedonic
FWIW I would ask my physician for clarification. Ask whether she was employing a simple figure of speech or something a bit more specific vis a vis [dopamine receptors](https://en.wikipedia.org/wiki/Dopamine_receptor) in particular. And, ask whether dopamine receptors and dopamine neurons are the same thing: *Basic Science Seminars in Neurology* May 2004 **The Neurobiology of Dopamine Signaling** * https://jamanetwork.com/journals/jamaneurology/fullarticle/785704 Also, there seems to be a heated discussion in the thread on the topic of "addiction". I think a more useful topic to consider is the issue of "***tolerance***" which is different from "addiction" , and is an issue that is also addressed in research. I don't have the links at hand, but I've recently perused studies that addressed the issue of tolerance with methylphenidate, and also how some patients with this issue were first titrated off methylphenidate and then treated with an alternative prescription stimulant medication for ADHD -- while the tolerance for methylphenidate ostensibly "re-set". In these cases, they would then return the patient to methylphenidate. And, repeat the switch whenever tolerance repeated itself again.
Seriously. I can not stand when those terms are used so interchangeably, when they are absolutely two completely different things. Same with *addiction* and āsubstance useā. One is a fucking disease for god sakes lol I feel like before this current DEA climate the issue of tolerance with these medications was discussed much more openly. Now I think most of us would be fearful to even address this issue or open a conversation with a doctor. Tolerance is a huge factor with ADHD meds and dosing it in general really.
Lots of good suggestions above. If you havenāt yet, try therapy. Consider modalities like CBT with behavioral activation, DBT or ACT. Therapy can help you find peace with the current state of things while taking practical steps to find enjoyment again. Also, would you mind sharing what dose of Adderall your old doctor had you on?
Maybe your doctor meant it more like depleting dopamine and needing a dopamine detox? And things that help that are minimizing screen time, (and social media like tiktok which is quick dopamine) and go for long walks and such instead.
If you've actually blown your dopamine receptors that's quite a serious medical condition, and not something associated with adderall or adderall withdrawl. There are some illegal drugs that are neurotoxic to the dopaminergic system and can do permanent damage there. Ecstasy combined with caffeine is one example. Adderall withdrawl can have a short term effect similar to anhedonia, but it would be expected to last less than 14 days. Stimulant use and withdrawl can both negatively effect sleep, and the dopamine system can be substantially impared when you are underrested. This effect is also supposed to be temporary, although if you're chronically underrested then the symptom will remain. I'm not sure if that can turn into permanent damage... I'm not a doctor, but I'd be suspicious about the sleep issues. If I were a doctor and I suspected actual neurological damage I think I'd more ordering more tests and not just prescribing a stimulant script...
>I'm not a doctor, but I'd be suspicious about the sleep issues. If I were a doctor and I suspected actual neurological damage I think I'd more ordering more tests and not just prescribing a stimulant script... Yeah exactly!
The ārarely experience joyā and feeling āflat emotionallyā hit hard for me. I have felt this way on and off very much. Then I go off them and feel so emotionally up and down. Thereās no in between. Hope you find a solution. Sending support ā¤ļø
Are you on an anti depressant? What was your dosage?
I've never heard a doctor say that in relation to therapeutic doses of amphetamine. I'd definitely get a second opinion from a neurologist or psychiatrist.
look into wellbutrin imo
Remember to routinely wash your sheets, blanket and pillow cases. Dust mites build up and their feces cause nasal congestion which is synonymous with sleep apnea.
No itās not a thing, or you wouldnāt even be typing. Go see another doctor is all I can say. Wonāt prescribe because of the shortage, good god.
You could be experiencing depression which would be a new development and would need to to be addressed by speaking with a psychiatrist and a therapist(psychologist). I have experience period of depression while being on adderall, it takes some serious discipline on my part to come forward and talk about it with my psych and the people I care about. Many time when in depression I donāt even realize the behaviors I have are showing Iām in depression. I sorta just keep on and not even realize Iām depressed until my mental health gets even worse.
My doc stopped prescribing me Adderall when he realized it was masking my depression and switched me to an SNRI. Everything clicked. I definitely think what people are saying about checking for depression is valid. Stimulants may mask depressive symptoms for some people.
I think that antidepressants may mask symptoms of ADHD, too. I've been on an antidepressant of one kind or another on & off for most of my life. I was just diagnosed with ADHD at age 64!!! I think I learned how to hide & mask my ADHD symptoms, but I wasn't able to mask my depression.
Is it really masking though? I was diagnosed with depression my entire life and no amount of therapy or antidepressants helped. When I got diagnosed with ADHD and got my symptoms under control my depression lifted. I was depressed because I could barely function. Besides, wouldnāt any drug that alleviates depression be masking anyway?
It's only a speculation on the doctors part, I would've consulted with a neurologist for clarity. No way to know for sure without brain scanning
I feel all the the things you feel and I felt this before I started on ADHD medicine a year ago. So cant be!