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Addicted or self medicating?

I am a recovering alcoholic, 4 years sober. Did this in psychiatric hospital I had been in several times because I suffer with bipolar 1 for 17 years. My symptoms are sometimes psychosis, paranoia and hallucinations along with depression and debilitating anxiety. These are for the most part treated with medications by my psychiatrist. 2 years ago he diagnosed me with ADHD and prescribed me Ritalin. Amazingly not only did it take care of my focus, concentration and being able to read, it also improved my anxiety, depression and bipolar symptoms. He explained that was common. So I continued to take it but needed more of it to work after a while. The dosage was raised a few times then he switched me to Adderall. Tried the XR at 30 Mgs made me exhausted and I was stuck the whole day suffering and pacing, anxious etc. Ended up on 60 Mgs immediate release. It didn't last long enough on me, maybe an hour and a half then terrible crashes unbearable. The crashes bothered my bipolar so I started to split the pills all day long about 8 times to make them work. Never took more than prescribed but was always paranoid I was addicted due to my addiction with alcohol. Anyway, this has gone on and it slowly got to the point where I had to run my life around the times I took them. Like going to the store, doing a chore, calling someone, even taking a shower. I was terrified of the crash of when they didn't work because it was a debilitating depression and lack of motivation to do anything. Psychologically I thought I could not accomplish anything except when I took it. This has made me miserable. All I do now is want to stay home, take them to get things done, addicted to 16 diet pepsis a day and smoke. My life is spent doing these 3 things afraid to leave the house due to being paranoid to go out. I have had several medication adjustments because my psychosis was getting bad and hallucinations, thinking the tv or radio was talking about me, all my mania made me depend only more on the Adderall, soda and smoking because the only time I feel normal without mania is doing these 3 things. I isolate and afraid to go anywhere without the safe feeling of these habits.  Have changed 2 antipsychotics recently and this all is getting worse every day because now I am going a little over the amount I am prescribed. I am depressed all morning where even the Adderall doesn't work and then come alive around 4 pm and then start to take the Adderall because I want the great energy to last. I always go to sleep early due to my night meds are sedating and see no reason to stay up when I have to stop the Adderall for the night. So I just take night meds and go to bed.  With all I have said my common sense tells me it's time to go back to the hospital to fix all of this. In 17 years it seems every fee years I need to go to adjust my illness. It's like maintaining a car. My bipolar gets out of hand and I decide as I see it gets worse to go back to the hospital. It is very frustrating because I don't know if it's the illness that makes me self medicate or the addictions come first. I know I am always dual diagnosed. Am I making the right decision going back?  I truthfully think it's all gone too far for my doctor to fix it with changing meds. I am terribly disappointed in myself after being so proud of conquering alcohol. It's a horrible feeling to be out of control of your own mind and life.
3 Responses
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1684282 tn?1614701284
MEDICAL PROFESSIONAL
Is it possible for you to try a different psychiatrist? There is more then one out there.  You can also try a university based clinic. They may be more innovative in theire approach.
Helpful - 0
Avatar universal
I have discussed this with him 25 times at least. I tried concerta few weeks ago for the 2nd time. Was horrible with my bipolar depression. I am so sick of talking about it with him. I asked him a few months back to wean me off the Adderall. This crazy man put me down in one day to 30 Mgs from 60. I couldn't do it. Terrible bipolar hallucinations and depression with paranoia. So I told him and he put me back. This is a real struggle for me.
Helpful - 0
1684282 tn?1614701284
MEDICAL PROFESSIONAL
You have a complicated psychiatric history that has to be dealt with carefully and in person. Your psychiatrist should be made aware of your difficulties since he is the one managing you medications. They don't seem like they are exactly perfect for you at the moment.  It sounds like Ritalin was a better choice of medicine for you and I am not sure I understand why he switched you to Adderall which tends to cause a lot more mood swings and emotional  issues.  Concerta may be a better way of delivery of methylphenidate (Ritalin), it has a smoother way over time of drug release and better bio-availability.
You must address your emotional and behavioral issues to your psychiatrist so that he can reassess and re-evaluate you to better determine what is  best in your particular circumstance.
Unless you bring the issues up with the doctor we do not know how to best treat you.  Please talk to his ASAP so you can be helped and function better. Good luck to you.
Helpful - 0

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