ADD / ADHD

As part of my bariatric assessment at the Cleveland Clinic, I had to have a neuropsychological assessment done after showing signs of Binge Eating Disorder (often co-morbid with ADD/ADHD) during my psychological assessment. I was done in 2013 -- before BED was an official diagnosis.

I do not and have not taken any drugs for it (not that I am against them, per se -- with the proper diagnoses and monitoring) -- but I have found relief via CBT (cognitive behavioral therapy).

I would strongly encourage you to get a formal assessment done via neuropsychological testing via a PhD psychologist or psychiatrist. I wouldn't use my PCP to treat ADHD/ADD/BED any more than I would use her rather than an oncologist to treat my cancer.

Although, in both cases (cancer and psychiatric issues), talking with your PCP first is often a good step. Not only does it keep your PCP in the loop regarding your health, but it is sometimes required by insurance for the purpose of referral.

At the risk of sounding pedantic, which is why I specifically stated "to treat..."

Obviously one's PCP plays an important role in both cases -- both in helping to identify issues/problems and in referral to a specialist for both correct diagnosis, treatment and insurance purposes.

However, it is my educated opinion that best course of on-going treatment in both cases requires the expertise of someone who specializes in the pathology, physiology, and efficacy of treatment.

Oh yes, I'm aware that you said "to treat" and I concur with your opinion about the best course of on-going treatment.

I added my comment to ensure that the OP isn't entirely dissuaded from talking with her PCP about her health concerns here and to reassure her that her PCP is a good starting point - even if not the end point.

I am pretty sure I have ADD too. I have always been good at school and very intelligent, but I have major trouble staying focused. I can usual work to get goals/deadlines done but it causes me MUCH anxiety and I usually have to wait until last minute when the adrenaline of a deadline kicks in.

I would ask your therapist to recommend a psychiatrist once you have really discussed this with her. Psychiatrists are quick to put you on medications which can have life-long implications. I would look at alternate treatments before you consider medications. I have been on Cymbalta for over 10 years and cannot get off of it due to side effects. No one ever told me that you may not be able to get off a psychotropic medication after taking it for a while. I wish they had. I wish CBT or other alternatives had been offered to me to try before medication. I wasn't given any alternatives 20 years ago when I was diagnosed with mood disorder and panic disorder. Also, vet your psychiatrist. They are not all created equal.

Best of luck to you!!!!

Thanks! After I started researching, I wrote out four pages of my own symptoms. It really explains a lot. When I told my wife, she said "Duh, of course you have ADD. Didn't you know?"

You can get off Cymbalta. I did for the first WLS. It's not pleasant while the brain adapts, no. You need to titrate down for several weeks and then discontinue. You absolutely cannot just stop taking it, which some dumb doctors will advocate. If you titrate off slowly it becomes far easier and more pleasant, especially if you prolong the time in order to do so.

I don't think there is any drug you can't quit, it just has to be done over a period of time.

The side effects of going cold turkey are awful, and I definitely wouldn't recommend it! I read about brain zaps and how bad they were but until I had them, I had no idea.

It doesn't help that most doctors often tell people to just quit taking it, which is another tangent entirely, and perpetually annoys me. The side effects can be horrifying, and they are cruel.

A few drugs should never be discontinued without medical intervention if there is significant dependence. Benzos are one, actually, because discontinuation can cause seizures and other issues if someone has taken a high dose for a very long time. Alcohol is another, because if someone's alcoholism has advanced, they will often die without medical care.

Serotonin imbalances can cause comas, too. Definitely something to avoid messing with.

Dear Nora,

It is not unusual for women with ADD to go undiagnosed. Many women have hyper focus which means you do okay usually at things you are interested in, which means school often isn't a problem. I recommend working with a psychiatrist and your therapist together. One great med is Intuniv/ guanfacine, which is for impulse control. As long as you do not have low blood pressure, it should be an easy option. I did not find stimulants helpful. I also take an SNRI called Effexor/venlafaxine, which helps with anxiety and depression. I will say they help with impulsive eating and spending, but nothing helps sugar addiction..sigh...my weakness.

Good luck. I am a mental health counselor, and the best thing to do as others here have said is work collaboratively between your therapist and pcp or psychiatrist.

Best regards,

Mary K.