Expert: Dr Billy Levin - 11/29/2009

Question
Dr. Levin. I'm a 36 year old female adult with ADD diagnosed since 28 years of age. I also have Bi-polar. I was recently switched to Ritalin LA which thus far has been the most effective. I've tried many. Anyway, I still have problems(I never thought medication would cure all my symptoms) My problems are organization, time management and getting things done. I know I have bills passed due but just can't get them paid. I can never stay organized especially at work. For me if it's out of site it's out of mind. i feel everything must be out on my desk or it won't get done. These behaviors are very debilitating. I see a therapist, hired a pro. organizer and have help from co-workers and parents and still I have major problems. What can I do?
Thanks for your help.

Answer
May I call a spade a spade and answer you very frankly. You describe symptoms of ADD despite being on medication. The reason is obvious. Ritalin LA can never work on its own. Thus two reasons for your problem. The LA might be too little and it cannot cover a whole days treatment on its own as it only works at most for 8 hours. A short acting Ritalin is usually needed as a top-up as the LA fades in the afternoon. Get your doctor to re-evaluate his treatment or see an expert. A therapist or organizer cannot solve problems if the medical treatment is ineffective. ADD is not a part time condition. Only an optimal dose covering the WHOLE day will be successful.