Friday, January 11, 2008

Bipolar with ADD?

"The National Comorbidity Survey showed that among adult patients surveyed ADHD existed comorbidly in 32 percent of those with a depressive disorder, 21.2 percent of those with BPD and 9.5 percent of those with an anxiety disorder."

So I start taking Adderall, a preparation of mixed amphetamine salts, and BAM! My crying spells stopped, I can stay home alone and be productive, and cleaning and organizing have never been so easy! I thought having three trains of thought at once was part and parcel of my bipolar disorder; now I think it is a symptom of ADD.

The paradoxical effect of "speed" on ADD and ADHD is counterintuitive, but the treatment response is 70%. Kathleen has always told me that I have a "busy mind." But now I can take one thing at a time, I can plan, I don't feel so rushed and fearful over each new task like I did just ten days ago.

In my family of origin I was the worst of slobs, but because of my high academic aptitude I was nicknamed "The Absent-minded Professor." Although my parents noted unusual powers of concentration in me, i. e. I could read a book with chaos all around, when it came to cleaning up my room I was flummoxed. And once I cleaned it I could never maintain any kind of order. This was hard on my brother, with whom I shared a bedroom for 16 years, as he was of an opposite nature. Literally one half of our room would be neat and the other a pig sty, I being the pig.

Since 3 to 5% of children are estimated to suffer from ADHD, that means that a bipolar child, particularly a male, has five times the chance of having the disorder. Lucky me!

I thought I couldn't have ADD because, for instance, during my senior year at UCLA I worked three jobs and maintained a full load and a 4.0 average without difficulty, thinking this a sign of some level of organization, though in truth I was rushing about in an agitated depression, seeking anything to fill my mind with something other than my mind.

To experience a brain that mainly assays one line of thought at a time is an incredible luxury for me; it is so much better than being driven by the chthonic winds of my associative whims.

My late daughter, Rachel, who suffered mightily from ADD, always insisted I had it as well. I think the girl was right, God bless her.

If there is a silver lining to this depression, it has to be the discovery of this other diagnosis. All my life my chief defect has been impatience. I always felt pushed, pressured to do things in the shortest amount of time--they had to be done yesterday! Now I am calm; my thoughts are not running ahead of me. I can't tell you how surprised I am at this; I thought my extreme impatience and fidgitiness were due to bipolar anxiety, not ADD. Now I think otherwise.

Here's a lesson: I suffered manic-depression without being diagnosed until the age of 30. I suffered ADD without being diagnosed to the age of 53. If I had been treated for both at an earlier age, God only knows how my life would have played out. For one thing, I think I would have been better liked, as my impatience feeds into my critical nature so that I share my opinions too frankly and too often. I'll beat a dead horse until it's powdered bone! So if you have serious questions about your mental health, do see a competent psychiatrist--even if you are successful by the world's standards.

Rejoice with me, provided this experience holds. (I have a strong sense that it will.) What will really be interesting is seeing those close to me notice my personality change. Maybe you can't teach old dogs new tricks, but you can get around it by giving them new drugs!




  1. This could be my husband's personality profile:

    "In my family of origin I was the worst of slobs, but because of my high academic aptitude"

    "I could read a book with chaos all around, when it came to cleaning up my room I was flummoxed"

    ADD medication changed his life. He started with Welbutrin, which worked extremely well for about a year and then quit working; now he's on an amphetamine derivative as well as anti-depressants.

    ADD and depression may have separate biochemical causes, but I think they easily become behaviorally linked-- I know that his depression is/was often triggered by his feeling that he hadn't lived up to his (very high) intellectual potential. Therapy never worked. Thank God for drugs.

  2. Anonymous11:36 PM PST

    Sounds like 2008 is off to a fairly good start for you. I struggled with alcoholism seven years ago, bad, so although I don't know how it feels to be you, I kind of know what that deep, dark, hole you've been in feels like. It's good to hear that from the depths of despair can often come glimmers of relief, and then hope. I'm very pleased for you. I don't know you, but I really am. Just happy you're feeling some let up. Look after yourself.

  3. Anon: Thank you, "I have always depended upon the kindness of strangers."

    Tiel, thank you for that. We're never alone, are we? We all suffer from terminal uniqueness. ;-)

  4. That is a very interesting post on anxiety disorder! In fact, to find out more about other useful tips on how to overcome anxiety disorder, check out
    , they have many great articles and tips to guide you.

  5. Bipolar/ADD Not Me!10:57 AM PDT

    I have been diagnosed with MDD for years, have tried every med known to man and ECT! I have my Masters degree and always been thought of as smart. Recently MDD turned to Bipolar disease (even though I don't want to accept that). Meds were not help/ my mind is like a jet--racing all the time. My psych NP decided that I may have ADD instead of all the rest...tried adderall(with hesitence)and wow many years of Hell has disipated!!!! GO PSYCH NURSE PRACTITIONERS (they are more apt to listen)!!!!!!!!!!!!!!!!!

  6. redlegdvldg4:48 PM PDT

    I was just recently diagnosed (In the last year) with Bi polar and ADD. I take Prozac and Abilify along with Ritalin, kind of an odd combination I think. If only I had been diagnosed twenty years ago I could have done better in school, but on the other hand I probably wouldn't have been treated properly: for I had no medical insurance then. Luckily I went into the military and the V.A. treats me. i feel lucky to have been diagnosed at an early age compared to you. My only hope is that the medication doesn't stop working over time.

  7. Anonymous12:40 AM PST

    Bipolar disorder is not a single disorder, but a category of mood disorders characterized by the presence of one or more episodes of abnormally elevated mood, clinically referred to as mania. Individuals who experience manic episodes also commonly experience depressive episodes or symptoms, or mixed episodes in which features of both mania and depression are present.

  8. Anonymous1:52 PM PST

    I am a medical student that was diagnosed with bipolar disorder 2 years ago. I assumed that my lack of concentration, flight of ideas constantly going through my head, and various other "hyper" issues were a manifestation of the bipolar disorder. Today I met with an academic specialist to talk about improving my study skills. After I described my study habits and took a survey, she suggested that I talk to my psychiatrist about treating my ADD. I have set up an appointment. It would be great if addressing the issue would help me to focus better. I am a little anxious about possibly taking ADD meds with my bipolar. Can they launch me into a hypomanic phase?

  9. Dear Anonymous,

    This is a dicey issue. Yes, amphetamines can aid and abet mania. But if you're on adequate thymolytic therapy, it can be monitored.

    There is much overlap in Bipolar and ADD diagnosis, esp. in kids. I found Adderall to be a help for me in focus, and strangely, it calms me as well. It was also part of the silver bullet that pulled me out of a two-year depression, along with Effexor and Abilify.

    I was an undiagnosed bipolar in med school, though I found the first two years easy, due to a good memory, I suppose.

    Good luck and I recommend you don't choose psychiatry as a speciality--pick something task-oriented, like surgery or physical medicine, that's my best advice. Avoid too much intimacy with patients and make your home your castle; try to avoid being on call as well--opthamalogy is always good!


  10. Anonymous8:35 AM PDT

    I'm 53 years old I have Bi-polar with ADD, I been told I have a learning disorder (grammer and writing )and should get it checked out any suggestion thank you

  11. Yes, do get it checked out--I'm sorry to report that my shrink took me off Adderall because of a manic spell. I've asked him to restore it but he is naturally hesitant. I do recommend you try the medication, as long as it doesn't provoke mania--watch yourself closely. No doubt you are on medications already so one more shouldn't be a problem.

  12. I'm glad to hear you're doing well!

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