Medicating With A Dissociative Disorder

[Poofycat]

(Moderators: I wasn't sure where to put this since it could go in the Medications and Substances section as well, but I chose this section since it's mainly info for those with a dissociative disorder. Move as you see fit.)

My T (he's a psychiatric nurse practitioner) and I have been working for a while to find a med regime that will keep me safe and functional while working through things in therapy. This has been difficult because I have a dissociative disorder. What we've come up with is apparently outside the box, so I thought I would share here in case others are struggling with a similar issue.

Standard meds are 10 mg Lexapro to keep the depression at bay, 5 mg Prazosin for nightmares, 25 mg Trazadone as needed for sleep. I try to avoid the trazadone because it's just too hard to get out of bed in the morning when I take that along with Prazosin.

I take 2.5 mg Adderall in the morning and another 2.5 at lunch. I've found that Adderall actually lowers my anxiety. Instead of stressing about everything I need to do, I can actually prioritize tasks and get things done. It's kind of amazing.

Benzos are bad, bad news for me. Benzos target the same receptors that alcohol does, and alcohol "unlocks the doors" for my parts. So benzos actually feed the dissociation instead of calming me down.

What do I do during an anxiety or panic attack since benzos are off the table? Most of the time I take Adderall. I found that this worked for me kind of by accident. My dad died this summer and I had panic attacks almost every day for the following couple of weeks. I had to travel out of state to be with my family, and of course my T was out of town when this happened, so I couldn't get new drugs and had to work with what I had. One day during a panic attack I knew I had to take SOMETHING just to feel something different. So I took some Adderall and it worked! Instead of feeling completely overwhelmed I could sort through my immediate situation and make sense of things. It snaps me back so to speak. My T was initially shocked that it worked, but when we talked a couple weeks later he said it actually did make a kind of sense and that he had learned something.

We just added Hydroxyzine to my med toolkit as a mild anti anxiety. Adderall works great when I have something to do like go to work or clean the house, but not when I'm just hanging out trying to relax (which is something I'm trying to learn how to do; hypervigilance is too strong right now). Hopefully this drug will chill me out enough that I can enjoy doing something like sitting in the garden without panicking.

Hopefully this info is useful to some of you. It might give you ideas to discuss with your doc if you're struggling with this issue as well.

 

[Friday]

Yep. Stimulants are calming for people with ADHD.

I'm walking around with durn near an espresso drip at present. If my coffee glass isn't in my hand, it's about to be. Roughly 4-8 shots of espresso an hour.

 

[7Cs]

I don't have ADHD but my son does.
I'm ashamed to admit that I have taken a few and it helps me prioritize what needs to get done when I'm overwhelmed and can't find where to start. For some reason I also feel more present and have more positive interactions with my family (like antidepressant?) Even though I actually feel more mellow on it I am oddly more productive.

Like I said I'm not proud of taking it and don't often but I have a history of self medicating with whatever is around. It's not "recreational" in my opinion because I'm not doing it for fun.

I'm prescribed lamictal and bupropion.

 

[Poofycat]

@Friday I definitely don't have ADHD, but do have attention problems. That's a lot of espresso!

@7Cs Most of the people I know who have an Adderall prescription got it because they tried some pills from a friend or family member and found out that it really helped. I don't think it's anything to be ashamed of as long as you're not abusing or depriving your son of his medication. Probably something to talk to your doctor about thought.

 

[7Cs]

@Friday I definitely don't have ADHD, but do have attention problems. That's a lot...

He usually has a few left over each month so I always save them for emergencies like running out! So the ones have taken have been "extras".
I'm afraid to talk to the doctor because I don't want to be judged or labeled a drug abuser. :/

 

[BuckarooBanzai]

Roughly 4-8 shots of espresso an hour.

Careful! One can OD on coffee. Seriously.

 

[Hope_N_Highwater]

He usually has a few left over each month so I always save them for emergencies like running out! So the on...

Thank you SO MUCH for sharing your experience with this!

I have ADHD. My SO does not, but has been starting to dissociate daily due to over the top stress. He is already on Ativan and does not want to increase that. Your suggestion is an option worth trying. It makes sense. I tell him that since his PTSD "relapse" for lack of a better word, its like his brain has ADHD.... forgetful, inability to focus etc. perhaps the med will add needed dopamine to his prefrontal cortex like it does to me

 

[Hope_N_Highwater]

Thank you SO MUCH for sharing your experience with this!

I have ADHD. My SO does not, but ha...

I use dextrostat extended release capsules... its worth a try!

 

[Poofycat]

I was taking Ativan (which is a benzo) before my T and I realized how bad the dissociation actually was and I was a mess. I hated it because it made me feel so disconnected from everything, but it was either that and kind of function, or continue to have anxiety attacks and not function at all. I'm so glad I finally found another solution.

@Hope_N_Highwater One question my T asked me before we tried Adderall was whether or not I drank coffee. I usually don't because it makes me too jittery, but I would if I really needed to concentrate to get something done. That, to him, meant that Adderall might be a good solution. Something to have your SO ask about maybe.

I tried an extended release capsule once and didn't like it at all. Apparently it works best for people who actually do have ADHD instead of people with just attention problems like me.

 

[Friday]

I definitely don't have ADHD, but do have attention problems. That's a lot of espresso!

I would reeeeeeeally doubt that / be surprised if that's accurate. It may be. But, to the very best of my knowledge, the only group to have the opposite-stimulant reaction / paradoxical effect to stimulants are ADHD folk. Even narcoleptic a and other who are Rx'd stimulants don't get a calming reaction from them. There are 3 subtypes of ADHD (ADHD-I = inattentive, aka the daydreamers, the hyperactivity is purely mental; ADHD-H, hyperactive, the most well known subtype, the hyperactivity is purely physical; & ADHD-C, combined, with both mental and physical hyperactivity.) You might want to check out the book "You Mean I'm Not Lazy, Stupid, or Crazy?!?" By Kate Kelly & Peggy Ramundo.

<chuckling> I don't drink that much espresso, normally, but when my anxiety starts running hot, it's a nice little bit of chemical soothing.

ETA... Disassociation is actually PART of all 3 types of ADHD, by the by. It's called different names, however. It's part of both hyperfocus (which is aaaaaalways a part of ADHD, as well as the more commonly known hypofocus) which is where everything in the world fades away except what you're concentrating on, whether that's a daydream or a ball flying through the air, nothing exists -not even biological functions- until the hyper focus breaks; as well as part of "taking a break from overactive senses" (whether just zoning out, or a few other versions of it) ADHD brains are taking on tons and tons of sensory information at all times, and both I&C generally have multiple thought-streams that exist at the same time, all of which just requires a break here & there, to avoid madness. It's in a few other places as well (like losing track of time, or having something in your hand one moment and not the next, or just suddenly sort of falling down/tripping over air, because your mind is elsewhere). There's a whole helluva lot of crossover symptom-wise with PTSD, not just disassociation (and also it's sister-disorder, Bipolar), but the causes & solutions are different. Oftentimes if Im experiencing a symptom, I have to hit it with both ADHD tricks, and PTSD tricks, because they're both contributing to symptom. Other times, it's just one, but it doesn't distinctly "feel" like one or the other disorder, so I hit it with both. Voila!

Careful! One can OD on coffee. Seriously.

ADHD, so no worries. If I drink too much I just take a nap.

 

[7Cs]

Thank you SO MUCH for sharing your experience with this!

I have ADHD. My SO does not, but ha...

Please don't take my experience as any kind of recommendation.
Taking medication that has not been prescribed to you can be dangerous!

Stimulant medication can be ADDICTIVE and it can cause SERIOUS HEART PROBLEMS.
There are lots of other negative side effects that can happen.

I felt I needed to add a little disclaimer.

Hope... If your s/o does try this please make sure it's in moderation.... limited in dose and frequency.
If he experience manic or aggressive behavior he should discontinue. I'm sure you are aware of these things but I just wanted to put it out there for safeties sake.

 

[mamachick]

Regarding the Adderoll acting as a calming effect, it may be the dosage. You take 2.5 mg? seriously?
I thought the smallest dosage made was 10 mg but not sure, and of course they can be scored.

I have a history of being slightly ADD. My daughter was diagnosed yrs ago and I tried Adderoll before I gave it to her and it did help. I managed well with coffee though so I didn't use it though offered it by DR. Years later, after traumatic brain injury, I have a sleep disorder (daytime sleepiness disorder-not narcolepsy) and was put on Adderoll for it...at least 10 mg though and 2 x a day. I had to take the am one to function. I lost too much weight and they stopped it a few months ago. I can't function at all without it.

One problem is with all of this is that there is so much speculation. Reporting is so subjective. On one hand I can say that it does not calm me, but gets me going and focused. It motivates me to do the things I need to do. (I didn't have ptsd until few yrs ago and am 58). The other side is that therapist thinks I may have had ptsd from childhood, but I don't agree. I do know that I learned how to adapt really well long before have ptsd, so if I did have ptsd, I am able to calm self and lower blood pressure unintentionally as a coping mechanism.

Without adderoll, I wake up and when I think of what my day will be, I don't want to wake up and I sleep longer. When I do wake up, I sit in bed and drink coffee and smoke for an hour and then take a nap. This can go on all day long with me just brushing my teeth and eating some crackers. In that case, the thought of the day could be causing anxiety, causing me to shut down and sleep. If that is case, then adderoll calms, enabling me to get up and go and do things.

It never felt like speed unless dose was too high. My best dose was 10 mg am, and I could skip pm often. However, after weeks of use, my body felt exhausted-like it was giving false energy and I would wake up and just wanted to rest some more-fully exhausted. I would force myself to take it though. Then psychiatrist said that adderoll is same as crack and meth and that I should have never taken it. This is same group of drs that put me on it 7 yrs ago.