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Possible psychotic symptoms are the only thing keeping me from getting assessed for ADD. Feeling stuck

7

7sgh9fhe2

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Possible psychotic symptoms are the only thing keeping me from getting assessed for ADD. Feeling stuck

This is my first post. I'll try to be succinct but there's a lot to cover.

I got assessed for ADD recently by a psychologist (unofficial, I have to go to a psychiatrist if I want it to become an official diagnosis). I wasn't planning on this, it just happened. I am not seeing this psychologist for individual therapy. They told me that it does seem like I have ADD, inattentive type. I'm a female in my early twenties.

I'm considering going to a psychiatrist with the goal of getting a prescription for something like adderall. I'm a college student and consider myself to be very ambitious. Though I've been successful in college so far, I feel like I've had to work a lot harder than I should because I struggle with ADD-type symptoms. The hardest things for me are paying attention to and retaining verbal information, remembering and keeping track of things, and sustaining focus during tasks like reading. I showed ADD symptoms as a child but feel like things have gotten worse as an adult. Whether this is actually the case or I'm just noticing these things more now because of the increased difficulty of college is something I don't know.

What's stopping me from making this potential ADD diagnosis official is the fact that I've experienced certain symptoms for about three years now (since I was 18) that seem like they could potentially be on the spectrum of psychosis. A big part of my major is psychology, so I'm not sure how that's influenced things. I've had anxiety since I was a child that mostly revolved around being harmed or having one of my loved ones harmed, so I don't know if these symptoms are just severe anxiety or something more. I'll try to briefly list the most notable ones below, roughly in order of when they first appeared. These experiences have come and gone in waves and in different combinations. There are some months where I feel like I'll be experiencing more of them and to a greater degree, and other months where I feel like I'll be experiencing relatively few of them and to a lesser degree (like right now).


  • A significant amount of fear and anxiety surrounding cyber security and online surveillance. I've easily spent 100-200 hours improving my "setup", which has lessened the anxiety somewhat. I won't get into specifics but the measures I take are significantly more extreme than 90% of the population.

  • A significant amount of anxiety revolving around having my valuables stolen. I can't leave the house without hiding my computer in an unexpected hiding spot, for example.

  • Persistent feelings of being watched. For at least a year I struggled with the idea that construction workers hid cameras in the air vents of my house. I couldn't shake this idea. Though I knew deep down it couldn't be true, the fears began to influence my behavior (e.g. avoiding doing certain things in certain areas of the house where a camera might be). I still do this to some extent, though it's gotten better. Thinking too deeply about this would cause very intense cognitive dissonance (because of a part of me "believed"/gave weight to these ideas and another part of me didn't, simultaneously), so I tried to not think about it too much. As time went on this developed into a more general feeling of being watched, which is something I do still deal with on and off: when lying in bed at night, when sitting near windows or digital devices, even when sitting alone on a bench. I had to cover the front facing camera on my phone because the feeling of being recorded/watched was too uncomfortable.

  • Social withdrawal and the intense desire to be alone and avoid interacting with new people. Feelings of hostility and even anger when my family would urge me to be more social.

  • Feeling unable to leave the house, like I was drawn to my house like a magnet. There were/are days when I just hate the idea of physically leaving the house. It fills me with so much dread and frustration because I don't really know why I have such a strong aversion to going outside.

  • Intense rumination and being lost "inside my head". At first I could spend hours lost in thought or having elaborate hypothetical conversations inside my head. Sometimes if this went on too long I would start to feel very odd, out of it, and dysphoric, like something was terribly wrong and I couldn't put my finger on what it was. For a brief period of time I felt very confused by whether there was a difference between what I actually believed and what I just thought I believed. This caused me to ruminate a lot on the nature of knowing, which was distressing because I felt like I could no longer trust myself or have solid opinions about myself. I would cope with all of this by listening to very loud music.

  • Intense guilt - for both minor things that most people probably wouldn't feel guilty about and for broader social ills that aren't my fault. This has rarely been tied up in feelings of grandiosity (e.g. I'm so gifted/special I could be helping to fix some of the worlds most challenging problems, but I'm depriving humanity of my efforts because I'm a lazy/bad person). I don't think I usually have grandiose feelings, though on occasion I have felt like I'm a somehow special person destined to do great things. This has helped me cope with everything else, because I tell myself that the emotional suffering I experience is part of my "journey" and in the long run will be "worth it" because I need to go through these things in order to reach my full potential.

  • More recently, I'll have odd thoughts that last for a very brief period of time (for a few seconds to a few minutes only), but while they do last they can feel very real. They get triggered by some suspicious stimuli in my environment. A waiter is standing in the corner of the room looking at our table for a little too long - food has been poisoned. A car has been tailing me for too long - they're following me. A car is parked in front of my house - they're waiting to rob us. I forgot to close the window blind before hiding one of my valuables - the neighbor saw and is going to break in and steal my things. Someone sticks their head into my classroom for a little too long before leaving - a school shooting plot is underway. Like I said, I can brush these thoughts off very quickly, although it doesn't stop them from popping into my head in the first place, which has been embarrassing. This doesn't happen every day and there are stretches of time where it won't really happen at all.
I also have severe trust issues (I trust no one in my life) and a long history of depression, which has worsened in conjunction with these other symptoms. I don't only experience the things listed up above when depressed though. I have depressive episodes that can last several weeks or sometimes several months. During these episodes I have felt suicidal. I did not have a traumatic upbringing and I know that my family loves me, although my household was very volatile and dysfunctional growing up.

When written down things seem worse than they are, so I constantly remind myself that a) these experiences take up a relatively tiny amount of my conscious waking life, and b) I'm a pretty high functioning person overall. I often feel like there's a chance that I'm reading too much into things - that my background in psychology has corrupted me by making me more aware of various psychological symptoms and therefore more likely to "feed" them somehow or even fabricate them from nothing. This has also exacerbated my guilt, because it's made me feel like all of this is my fault, or that I could overcome these things if I had more discipline.

As I mentioned at the start of this post, I also often feel like this could just be severe anxiety. If this is the case, then I do want to try taking something like adderall, because even though stimulants can worsen anxiety the chance of long-lasting, permanent damage is relatively small. There's the lingering fear though that if I take a stimulant it could trigger some underlying psychosis. I've read stories of individuals who became acutely psychotic with zero insight extremely rapidly (sometimes with no apparent trigger at all) who never really recovered, which obviously terrifies me.

I feel extremely conflicted. On one hand, I feel like treating my potential ADD could really have a positive impact on my life. I'm nearing the end of college and have been presented with several high-level opportunities, so the stakes feel so high. I don't want to miss my chance. I want to seize these opportunities and make the most of them by operating at my full potential, without something like ADD hindering me. On the other hand, I do worry that maybe these other symptoms aren't just anxiety and/or depression and/or ADD, and that taking stimulants could be a terrible idea. I don't know which of these theories I believe more since I feel like there are arguments supporting both. One minute I'll believe the first one and then I'll flip and believe the other one. Sometimes I believe both at the same time (more cognitive dissonance...).

If these symptoms sound more like anxiety/depression/ADD, then I want to try to tackle these attention problems head on without letting the small chance that it could trigger something else get in the way. The one thing I don't want is to be left in some limbo where I'm told by a psychiatrist "while you don't have psychosis, there's a small chance that you could, and based on that small chance I'm not going to treat your attention deficits". Because of this, I feel conflicted about what I should and shouldn't share. I've heard that if you get put into the category of "people who shouldn't take stimulants", it becomes very, very difficult to find any psychiatrist who will be willing to help you with ADD symptoms directly.

Thanks to anyone who made it this far.
 
A

AK

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Hey

I feel like alot of your problems are coming from men .. sad/scary perverts. Um .. If so, you're not alone on people who isolate themselves from negative people,.. or so even tones. I think you have a good head on your shoulders as far as staying dreamy/happy or positive. Also, sometimes the tones your hear may make you think something totally ridiculous, but maybe try adding a positive thought or tone instead.
It seems like you're pretty positive already, I dont remember reading in your post if you have schizophrenia or not.. but if you do the less adderal the better, the psychiatrist can make an adjustment on your anti psychotic to compensate. However, if you dont have or never had schizophrenia, I probably wouldnt worry about it too much, at least at a low dose maybe. .. uh are you asking if this adderal is going to put you in a sad/scary mood? .. Sorry, i couldnt find what dopamine receptors adderal works on, but if it is D2, thats the one associated with schizophrenia. If you're really worried about it, try or ask for a low dose of an antipsychotic with the adderal.
And I do the same thing, I stress out about stuff too, but its only to make me a better person, I am now just getting to where I wanted to be by doing so. :)
Stay Positive :)
 
Cazcat

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I think the best thing to do would be to discuss all of this with a psychiatrist. They will be the best person to assess if a medication is suitable for you, and may have other options if it is not.

I am not a Dr, but to me what you describe sounds more like anxiety than psychosis based on the large amount of insight that you have into all of this. In general with psychosis people don't question is what they are thinking is true or not, because they are sure that is what is happening.

Ultimately whatever is going on the psychiatrist should be able to help with it.
 
boudreauj4

boudreauj4

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You sound like most of your psychosis has a paranoid flare to it. You also said you had depression. There is a diagnosis called major depression with psychosis, so maybe your depression is causing the psychosis. Is your depression being treated? I would think that depression can cause cognitive troubles that might resemble ADD.

I have schizophrenia and I have cognitive disabilities due to it. At one point my psychiatrist mentioned that I might try an ADD medication to help with it, but she later changed her mind. She said that after reading up on it, she read that those types of medications don't typically help people with schizophrenia.
 
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7sgh9fhe2

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I think the best thing to do would be to discuss all of this with a psychiatrist. They will be the best person to assess if a medication is suitable for you, and may have other options if it is not.

I am not a Dr, but to me what you describe sounds more like anxiety than psychosis based on the large amount of insight that you have into all of this. In general with psychosis people don't question is what they are thinking is true or not, because they are sure that is what is happening.

Ultimately whatever is going on the psychiatrist should be able to help with it.
Thanks for your input. While I'm sure much of this insight stems from my interest in psychology, I also feel like it's probably too high for psychosis. That's probably the strongest argument against it in my mind. I do worry that something like adderall could worsen anxiety, but it's a risk worth taking for me if it'll help me in other aspects of my life. I just wanted to consult with people on this forum to see if I sound like someone who's "at risk" enough that taking it would be a very bad idea.
 
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7sgh9fhe2

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You sound like most of your psychosis has a paranoid flare to it. You also said you had depression. There is a diagnosis called major depression with psychosis, so maybe your depression is causing the psychosis. Is your depression being treated? I would think that depression can cause cognitive troubles that might resemble ADD.

I have schizophrenia and I have cognitive disabilities due to it. At one point my psychiatrist mentioned that I might try an ADD medication to help with it, but she later changed her mind. She said that after reading up on it, she read that those types of medications don't typically help people with schizophrenia.
Is it really psychosis though? That's what I can't make up my mind about. On one hand I know it's possible (albeit uncommon) to have pretty high insight into paranoia/delusions, but on the other hand I'm also aware that this insight + the duration of symptoms makes it unlikely that this will rapidly progress into something more.

My depression is currently being treated with Wellbutrin but I feel like it isn't very effective. Even if the cognitive troubles are a result of depression instead of ADD though, I still feel like adderall is worth a try. I've read about people with depression who said adderall really helped them, and so long as the cognitive issues are being improved, does it really matter what caused them in the first place? These success stories are what make it so tempting to just focus on the cognitive/attention issues for now while leaving the other stuff off the table.
 
Per Ardua Ad Astra

Per Ardua Ad Astra

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ADD? That's Attention Deficit Disorder, isn't it? :)

It's more commonly diagnosed as Attention Deficit Hyperactivity Disorder (ADHD), though I know attention and hyperactivity can be stand-alone issues, and one is sometimes present without the other :)

Concerning psychotic symptoms precluding assessment for ADD. ADD like ASD is a neurological disability that people are born with, and is lifelong, though their effects can be addressed and ameliorated to some degree. Early intervention and assessment is the the better way here :)

Psychotic issues can, and often do, exist alongside neurological disabilities, and they are not mutually exclusive. So any disability or issue you may have, ought properly to be explored and assessed, and a diagnosis given if appropriate :)

In any case, many people with ASD were at one time, quite commonly diagnosed with schizophrenia and related psychoses. This is because some of the perceptual differences now understood to exist between people with ADD/ASD etc, and those who deemed 'neurotypical', and coping behaviours, meltdowns and such like, were often mistaken for psychotic symptoms :)

I have had an historical diagnosis of schizophrenia for many years, and last year at aged nearly 50, was finally diagnosed with ASD and ADHD is still under investigation, and have been told is almost certainly present. Last week my consultant in general psychiatry, told me that schizophrenia was now off the radar, and that people's problems had been misunderstood :)

I now have a consultant psychiatrist in a specialist neurological service, and can go back to general psychiatry should I need to :)

Best advice is, if you feel you may have the disability, then push for an assessment, and keep on trying til you are listened to, and assessed :)
 
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