Expert: Christine D. DeLoatch, MA CCC-SLP - 10/8/2009

Question
Hi,Christine. When I was 15 I attempted suicide and was hospitialized. The doctor wanted to put me on medication but my parents would not allow it. I should also say prior to that I had issues of hyperactivty and behavioral problems.Looking back I have always sought out every form of stimulation from conflict seeking ,ciggarettes,sugar,drugs, coffee you name it - this is why add/adhd is most likely an issue.  Yet, that is only part of it I have sufferred from depression ... I would often have crying spells but because  it happened so often it was a norm for me.  The first of meds that I have taken was Wellbutrin (about 5 years ago)my purpose was to quit smoking and it helped.  After I kicked the habit completely I stopped taking the medication. I was able to function  until about 2 years ago ( I still had add/adhd symptoms but they have actually become a norm for me and have defined who I am  so I have learned to embrace and accept) Well I was having major issues with depression these qualities, habits and traits because of add started to get out of control effecting my work finances and relationships.  I self medicated my self with taurine which worked for a little until I started to get anxious and really hyper. I finally went to see a doctor she prescribed Lexapro which did wonders for me. It worked so well when the  prescription ran out I never went back to get it filled .Then the depression and anxiety came and I went back to see my doctor who prescribed more Lexapro( 6 months worth) I started to get really hyper  and I stopped taking it again.   I was fine  for a little while until I noticed a change in  my behavior, temperment and performance and  I knew I  needed something. This was all decided going into a new year which means new insurance and new rules. Well I could no longer take Lexapro. So a new doctor prescribed citolapram it was not effective as Lexapro but it was enough to get me by until it made me hyper.  I stopped again but this time I felt since I was under the care of pysc I was ok. I was however experiencing major issues with focus.So.I was  prescribed Wellbutrin I had  taken it for about 4 weeks with no success in fact I was more depressed and angry than before (even experienced suicidal thoughts) I failed to remember that when I had taken it years ago I did it to quit smoking looking back I was kind of angry then- thought it was from nicotine withdrawals.  Well my doctor took me off that and put me on ritalin 5mg twice a day. Its ok for the first hour or two- I am focused once it wears off ther is a major differrence. I don't think I am depressed but I do notice that I have been having issues with letting things go and -I have also  been slightly  parnoid/anxious/obsessive (I always have been -another accepted norm my father/sister/brother has some issues with these too as well undiagnosed add). I should also mention that I  have the hardest time waking up in the morning which could be depression.
I read that you are familiar with spect studies.  Well I have read his book and I can relate with those with prefrontal cortex issues and those with an over active cingulate (if I remember correctly) If you can be of assistance it would be very much appreciated.

Answer
Dear Sheila,

Thanks for asking me your question.  5mg. of ritalin twice a day seems like a very low dosage.  I would strongly suggest that you discuss with you MD either increasing your dosage, consider a longer acting form of ritalin or consider another stimulant.  Please continue to monitor yourself for rebound symptoms - irritability or other things that are usually related to a sudden drop in levels of medication in the body.  

I'm sorry this reply is so long in coming. The first reply must not have been processed.  

Please feel free to write me again for additional information.  

I would also recommend you look into a book called Over-load: Attention Deficit Disorder and the Hyperactive Brain.  It is very interesting.  I think you will find that anxiety and depression are not so unusual for those of use with pre-frontal cortex issues.  

Many Blessings to you.  

Christine