Forum topic: New diagnosis/Coaching

Forum: 
Hi, my husband, age 35, has just last week been diagnosed and within a week or two will be put on medication, Ritalin we expect. We took over a pizza restaurant last year and the stress of that is probably what precipitated such extreme behaviour this past year...anger, irritability, gambling, lots of electronic toys, severe procrastination around home, etc, all the classic symptoms, it turns out. Obviously there aren't ingrained or habitual time management and goal oriented systems in his daily life, but this is something that we are in serious need of to run the restaurant and our lives more effeciently. He seems to think that beginning to be coached in these things would be too much to take on right away, being newly diagnosed and only beginning medication. I would like to see it begin as soon as possible but am looking for advice regarding this. We live in a fairly rural area of Atlantic Canada that doesn't have a great deal of support networks set up specifically for adult ADD, so would be looking for coaching systems that would be available online...any suggestions. I think it is important for him to have someone neutral other than myself to try to direct his progress...???

Comments

Hi there. My partner has ADD and I have spent alot of time learning about the disorder and how the brain of a person with ADD can tend to function. I've also read some interesting tips on adult ADD'ers taking medication and how it can help them. Once he begins medication, I suspect he will see results immediately, within the first 20 minutes of taking it. I don't know much about Ritalin, but I do know that about Adderall. I read that a person with ADD, for example, someone with impulse control will say anything that comes out of their mouth without thinking, their brain doesn't have the chemicals it needs to put brakes on those thoughts that are going to blurt out of their mouth. Therefore, it is said before thinking about it because the brain isn't telling them to not say it. Medication, is a brake system. If a thought comes to mind, it will put the"brakes" on, in a way to regulate the impulsive thoughts from being blurted out. With medication, the brain in essence can say "Don't say that!!!" A person who takes medication has an easier time when being coached or becoming self aware, because the medication assists the other chemicals in the brain to function properly, so that they can actually process the coaching thats being presented to them. It will help him focus more, and pay attention to what he is learning. My thoughts would be to at least wait until he starts the medication and see how the medication works for him. Try not to push things too fast, as with the new diagnosis and stress from the business; it might just be too much to take on at once. It is good that he is taking the steps and seeking help from a doctor, as well as, wanting to take on the coaching. Right now, the thought of coaching in his mind is overwhelming, once he begins medication, he can think more rationally about when he should/shouldn't start the coaching sessions. Things will be much clearer. I wish you both the best, and I hope you can find a happy medium.

If your husband went from working for someone else, where job parameters were clear and he knew what was expected of him and when, now he is transitioning to working for himself and taking on all those layers of responsibility, that could certainly have triggered full blown ADHD behaviors. All that input is basically running around inside his head looking for a place to sit down. He sounds like he' s scrambling for a foothold. Stay close to your doctor as your husband transitions with the medication. While his body adjusts he may be jittery, like on too many cups of coffee. Another adjustment that I have seen people go through is that they can tend to get frustrated with others around them for entirely new reasons...now that they can get all their ducks marching in a row they may wonder what's wrong with everyone else! There is a lot of literature available to help you, and this site is marvelous. What an adventure you'll have Colleen
Colleen

Thank you, Colleen, for some of warnings about what can happen when starting medication. My husband drinks a fair bit of Pepsi, so I will show him your post, and maybe try and get him to cut back on the caffine before he starts on the meds. I seem to recall reading that ADD people on meds should limit their caffine intake as it reduces the effectiveness of the medication. And dealing with his frustration will certainly be nothing new! We'll just have to see where it leads us now! I am eagerly awaiting being able to see him with his ducks in a row...and as you can see, I am no stranger to the literature that is out there. I am a voracious reader, so will be extremely well informed! I asked my husband about reading the other night, because I used to own my own bookstore before we took over the pizza restaurant, so have always loved reading. He has a ton of books he has picked out or I have given him over the years, but he has hardly finished one. When I asked him the other night, he said he loves to read, but just can't concentrate long enough or sit still long enough to allow himself to enjoy the task. I am hoping this will change with meds, as there is nothing better than sitting and talking about a good book!

Thanks for the comments, so far. I guess I will just have to take a step back and a nice big breath for a bit yet. I have been doing most of the reading and research on the subject, as of course he doesn't have the time or concentration to be reading much of anything. But I HAVE been highlighting alot, hoping when he does get to sit down and read a bit that he will take in the most important aspects more quickly! In fact, I think my highlighter is almost dry by now. I have read Hallowell's two Distraction books, and Wiess' ADD in Adults. I also have a workbook and an organization book that I will tackle, and I have Amen's book on the six types of ADD to read as well. Am also probably going to sign up for the online conference in September, as computers hold more interest for the husband than books do, so maybe he will be able to take in more info that way. Thanks again for the input...this is a great forum to have found.

Wow! You are doing a lot of research! Thats a lot, for even my brain to absorb at one time. Once he has himself settled, try to gradually give him the information bit by bit to a point he can handle so he doesn't get overloaded. I'm curious about the online conference you referred to. What does that consist of? Maybe my partner would be interested in something of that sort. I wish you both the best, and a prosperous year! Good luck with the restaurant as well.

The conference takes place over three days, and if you type in Virtual AD/HD Conference in Google, it should pop up. On the main page there is a tab at the top left for the agenda, and it seems to be a really comprehensive coverage of all the topics, for both adults, children and parents. Hallowell will be speaking, and Amen and lots of others about coaching, nutrition, exercise...you can call in, the stuff is downloadable to watch at your (or your ADHD person's!) leisure. So I think I will be signing up for that in the next few days. We had a meeting with the family doctor today, my appointment but he is very flexible about who is there for what. Said the husband will probably be put on Concerta first and see how that works out, but he hasn't received the evaluation yet, so wasn't able to do more than discuss it yet; by next week, hopefully. http://www.adhdconference.com/

Thanks for the information regarding the conference, I am looking forward to reading more about it tonight. Is your family doctor treating your husband, or is a specialist treating him? I've never heard of Concerta. I hope that it will work for him and better the situation for you both. I remember when my partner started taking his medications, I can look back at it now and laugh, because you'd know if he took it. He'd never stop talking. haha! One tip: try to be patient as the doctors regulate the proper dosage for him, it could take a couple times to find the right level, and the times throughout the day he should take it. All of these are important so that he remains on an even keel.

Thank you for the tip...before the diagnosis, patience was on short supply for me, having to deal with all the traits and irritations of ADD and not having the background of knowing where it all stemmed from. The husband and I were having lots of personal difficulties, between taking over the restaurant, lots of incomplete tasks at home, unfinished business, etc. I was just about to the breaking point and finally said he had to get professional help. I made the appointment and to be fair said I would see someone as well. This was about three and a half months ago now. He had seen various people over the years for anger management, had the teen problems with disruptiveness, social services involved, etc, and this spring spent a large amount of money online gambling. I have had more sessions than he has the last couple of months, but mine were more for coping and venting, but our two therapists swaped info as it was originally intended for couples therapy but working on our own issues first...all my issues stemmed from him! Anyway, long story short, between the things I said and the things he said, his therapist suggested about three weeks or so ago that he needed to be screened for ADD. I happened upon two books on Adult ADD, and from all the info figured that this was my husband and my situation to a tee! I don't know how many times the past few weeks I have seen people write that the authors must have seen into their lives, well that is kind of what it was like with me and my highlighter! My last session with my therapist, mostly I talked about the probable outcome of his referral, and that it really didn't pay for me to pressure my husband into the tasks and projects the therapist and I had discussed previously, because if ADD were the root of the problem, until we had that tackled, nothing I could do would be of help. So then this is passed on to the husband's therapist, and she gives us as our homework the title of a book to read, "Emotionally Abusive Relationships"! She said I was focusing too much on the ADD as it wasn't even diagnosed yet! Needless to say, my husband and I were both a bit ticked off, and in the end, justified, as two days later he had his consult and the psychiatrist didn't even need to talk with me. That report is to be forwarded to his therapist, who is a psychologist, not a psychiatrist, and the family doctor who will work things out with us after he gets the report. The doctor who did the consult is apparently just a visiting doctor but was also going to make the recommendation that my husband be treated by a psychiatrist. Now it's just a bit of a waiting game until the reports come through, though our family doctor was going to try to chase them down by next week to get the ball rolling.

Sounds like there were too many hands in the cookie jar so to speak. The good news is, the family doctor will be the person who you will working with you both, together. None of the information will be miscommunicated either. It looks as if you were educating yourself, and explained your theory to your doctor, and it got spun into another scenario. In reality, you were right, if the ADD is the root of his issues, no sense in tackling the things that could be related to the ADD and are essentially out of your control. Its so hard to try to explain your situation to a person who isn't on the "inside" of the relationship, as it seems in your case it causes misjudgement to be placed. I'm sorry you had to go through all of that frustration. I will say, that reading these forums, I was blown away because it described alot of things going on in my relationship, as if it were my relationship. It was so surreal. I even took it to my partner and I asked him to read it and his response was: "It sounds just like us!!!!" Did you find it to be a relief to know what has been or may have been causing some issues in your relationship with your husband? I found it to be a relief because it just made everything seem so much clearer! All the things I thought were there, were real, and I wasn't going crazy. At least that is how I felt. You will also grow as a person as a result of all this. I know I have, and still am learning/growing. I've learned alot of things that I was doing wrong, especially in the way I reacted to things. I hope that you guys can get to the doctor soon and start treatment therapy. Is he anxious, excited? How does he feel about the diagnosis?

We both were relieved to have found a reason for his behaviour, and have talked a bit here and there...our schedules don't allow for a lot of alone time right now, so it is a bit difficult. I was just glad to know that I wasn't just being picky or a bitch! I know he would like to get medication started as soon as possible, and so would I. I am really curious to see if the effects are going to be as dramatic as I have read...right now, we need some of that to get a few things done!

From my own experiences, the effects are dramatic, in fact...incredible. Its almost instant...but unfortunately, only lasts 4 hours. I'm really glad that your husband wants to improve how he is acting, not only for you but for himself and his health. I wish I could say the same for myself...I don't know about you but this roller coaster ride is beginning to drain the life out of me. The bad news is, I'm on a down hill slope and it isn't looking too great. With that said, from lessons learned, its still going to be tough, and there may be some great days, and some really hard days too. If he keeps pushing himself and with your help, I think you both will move gracefully forward. I'm really glad to hear that he wasn't shameful of the diagnosis, and he feels better knowing that it can be better too. I'm so excited for you. You'll have to keep me posted on how the conference goes as well.

A note to you about starting meds - finding the right ADD med is a matter of trial and error.  Concerta is a stimulant, as is Adderall, and both of these come in long dose forms that last 8-10 hours and short dose that last only about 4.

Some people don't do well with stimulants, though perhaps someone who has been drinking lots of caffeine will (this is also a stimulant).  Set it up so that your husband keeps a journal about how he feels at various times of day with the meds, and whether he is having side effects such as less appetite, trouble sleeping, facial twitches, headaches, etc.  Also, some people notice a cranky period as the meds wear off (often around 4 pm).  You, too, should take note of how your husband is doing, as you will find that you have a different perspective than he does, and your input can help (sounds as if he is open to this).  The ideal is to find something that doesn't bother him at all, but addresses his key symptoms.

If Concerta doesn't work, there are other possible options, such as a couple of anti0depressants that work for some people, as well as other stimulants, and also a newer med that is neither.

He should also be aware that the meds are not "magic pills".  They do a lot in terms of helping people focus, but once he can focus, then he'll need to spend time building the support systems he needs to succeed.  In his business, this may include reminder systems, schedules, rituals, etc.  None of this will come immediately, and he may need your help or the help of a coach to find things that work for him.

More info on various medical and non-medicinal treatments can be found in Delivered from Distraction if you have it.

Best of luck!

Melissa Orlov