Time-blindness from Ritalin? Missed appts, forgetting to eat....

[Blahblah]

UGGHHHHH. Just totally missed important Dr. appt this morning due to Ritalin....  I thought that Ritalin helped with staying on top of things!?  I started taking IR (vs longer acting) because I no longer feel any effect with extended.

Got up 9:45am, took meds, breakfast, started replying to a few emails. Must've got absorbed (didn't realize over an hour had passed). Then my heart starts pounding, because I had to leave for appt & hadn't taken a shower...forgot it takes 40 mins by bus to get there....

Part of the reason i take Ritalin is to stay organized & on top of things. And it's making me MORE TIME-BLIND, SLOW, LATE for stuff...More often, I am losing track of time (focusing or obsessing on non-important tasks) and then I miss/forget important stuff. Failing to estimate how long things/travel will take....

Is this typical?? I don't want to tell pdoc, because it is literally the ONLY med that helps me with apathy, ability to initiate/complete tasks. BTW, I only took 10mg IR this morning (usually I take 20mg extended) and I get stuck, unable to switch tasks....

HELP. How do you mitigate? Put neon post-it's everywhere with strict (minute by minute) time schedule??? 😩

Edited January 26, 2022 by Blahblah

[Blahblah]

I'm noticing an obsessive-type focus on doing things perfectly....For example, when writing emails, I often re-read/edit/tweak the email like 7 times (then re-read 6 times before sending it)!  I will look at the email address I'm sending to repetitively, to ensure that I don't accidentally send to the wrong person..... It's insanely time consuming, and over meticulous....

I have never been diagnosed with OCD - never had "over the top" obsessions or compulsions, but with my example above, could this be an perfectionist/OCD behavior exacerbated by Ritalin?  It is really causing a problem with me switching tasks, being late for things, etc.

Now obsessing about reading articles explaining this behavior:

https://www.additudemag.com/slideshows/symptoms-of-ocd/

For reasons that are not known, stimulant medications, often used to treat ADHD, may exacerbate an existing case of OCD. Often, the first clue that someone has ADHD and OCD — or may have OCD rather than ADHD — is a significant increase in OCD behaviors after taking a stimulant medication. Once symptoms of OCD are under control, a stimulant can often be reintroduced without causing a flare-up of the OCD behaviors.

OCD is easily confused with ADHD due to overlapping behavioral symptoms. For example, a child who has trouble completing schoolwork may seem inattentive; however, the problem may actually stem from a fear of making a mistake (perfectionism) that is so intense that he is unable to move on to the next task.

 

[CrazyRedhead]

@Blahblah, although I can't diagnose, I would really suggest letting your pdoc know about these symptoms (losing track of time, forgetting things, being late, editing e-mails over and over, etc).........These symptoms are affecting your life in important ways, so I think you should let pdoc know.....

You don't have to even mention your Ritalin, just let doc know about the symptoms.....You don't deserve to have all this stress....

Edited January 26, 2022 by CrazyRedhead

[Blahblah]

Thanks for your reply @CrazyRedhead  Pdoc (and everyone) out of suggestions. I'm not improving. These symptoms (NO motivation, no interest, avoiding appts to lay in bed, avoiding all social activities) are as bad as the major sobbing depression. There is really no treatment for this symptom....!  Stimulants just stop working.

I've tried increasing Ritalin (now it only creates problematic overfocus & tolerance).... My main problem now isn't focus - it's apathy, avolition...inability to initiate or complete anything productive (without outside force, punishing consequences)...no enjoyment of anything... Difficulty doing daily essential/basic things (getting out of bed at a decent hour, going outside, getting dressed, cooking a meal). Antidepressants just make this symptom worse.

So increasing Ritalin does not help...taking breaks is destabilizing. Can only try longer breaks & reinstating in order to milk more benefit. There are no other types of stimulants legally prescribed here (like Adderall, or even Vyvanse) Anyway, the whole stimulant train makes me feel like a drug addict, unable to function without this prescribed "speed" ... I increase Effexor and it just jacks up cortisol/adrenalin and causes rapid heartbeats....I've been reading studies that longterm/continuous Ritalin use actually exacerbates depression and probably give me arrhythmia.

I think I've permanently screwed my brain, fryed all my receptors....because I've been on psych meds 25 years... way too long. And on the outside, it just looks like I'm just " lazy & procrastinating", but it's waaaaaaaaay beyond that. Tell me, is it NORMAL to lay in bed staring at the wall for hours, days on end....??? Do I need to start over, do ECT??

It's completely paralyzing.

 

[CrazyRedhead]

2 hours ago, Blahblah said:

I think I've permanently screwed my brain, fryed all my receptors....because I've been on psych meds 25 years... way too long. And on the outside, it just looks like I'm just " lazy & procrastinating", but it's waaaaaaaaay beyond that. Tell me, is it NORMAL to lay in bed staring at the wall for hours, days on end....??? Do I need to start over, do ECT??

It's completely paralyzing.

 

You could ask pdoc about doing ECT, and see what they think......Other options you could ask about might be ketamine therapy:

https://www.health.harvard.edu/blog/ketamine-for-major-depression-new-tool-new-questions-2019052216673

Or TMS (Transcranial Magnetic Stimulation) therapy:

https://www.health.harvard.edu/blog/transcranial-magnetic-stimulation-for-depression-2018022313335

I don't know if these are available where you live, but they might be worth asking your doc about.

Edited January 28, 2022 by CrazyRedhead

[Blahblah]

My current pdoc shudders when I mention ECT (I see her once every 2 months) so she doesn't see me at my "worst." I appear incredibly functional/ stable. Plus i'm terrified of going through it for cognition / memory reasons. ECT is usually reserved for folks hospitalized, or after attempted suicides.

In every TMS testimonial I've read, people said it literally did nothing. Maybe they felt lighter for a few days. but mainly no benefit. I don't even know if it is available in Europe... Even in the US, I'm pretty sure that no insurance covers it...

Ketamine, I've heard reports that it can help people with treatment-resistant depression (more of the suicidal-type, dysphoric, agitated depression)....My main issue with it, is that it's 100% a dissociative drug. I already have problems with dissociating / avoiding / spacing out in bed all day (which is a negative / dysfunctional coping mechanism), and I don't think a drug that increases that symptom will help in my situation.

Edited January 31, 2022 by Blahblah

[Blahblah]

11 minutes ago, Blahblah said:

Accidental double post...

 

Edited January 31, 2022 by Blahblah

[CrazyRedhead]

2 hours ago, Blahblah said:

My current pdoc shudders when I mention ECT (I see her once every 2 months) so she doesn't see me at my "worst." I appear incredibly functional/ stable. Plus i'm terrified of going through it for cognition / memory reasons. ECT is usually reserved for folks hospitalized, or after attempted suicides.

In every TMS testimonial I've read, people said it literally did nothing. Maybe they felt lighter for a few days. but mainly no benefit. I don't even know if it is available in Europe... Even in the US, I'm pretty sure that no insurance covers it...

Ketamine, I've heard reports that it can help people with treatment-resistant depression (more of the suicidal-type, dysphoric, agitated depression)....My main issue with it, is that it's 100% a dissociative drug. I already have problems with dissociating / avoiding / spacing out in bed all day (which is a negative / dysfunctional coping mechanism), and I don't think a drug that increases that symptom will help in my situation.

I can understand how you feel about the ECT.

As far as TMS goes, my insurance does cover it, although I can't afford the huge co-pay.....It is an FDA-approved treament for depression here in the U.S.....My pdoc actually recommended me for it, but again, can't afford co-pay of around 2K.