Seeking Advice & Wisdom Concerning Career, Medications, and Life in General

[spacecatpj]

Hi everybody! My name is Penni and I'm looking for some advice/guidance/wisdom (or whatever else you may have to offer! LOL!) I was recently told that I likely have ADHD at the age of 43 (GULP!) and I was recently placed on Adderall XR 20 mg and it was just titrated up to 30 mg. The doctor (Psychiatrist) placed me on the long-lasting Adderall (Adderall XR) because I don't do a good job of remembering to take medications (unless it's in the morning). Before this, I'd already been diagnosed with recurrent depression and anxiety for years as depression and anxiety run rampant in my mother's side of the family. Anyway, the Adderall XR has certainly calmed me down!!!! Now I'm hoping the Adderall XR can help me to focus long enough to get all of my paperwork done on a timely basis as I have to have all of my paperwork turned in within a 24 hour time frame or else it becomes a "performance issue" which could lead to termination (I'm a licensed Medical Social Worker with a Master's Degree who works for a private home health agency in Iowa) . My supervisor sent out a memo on 10-02-09 stating that efffective immediately, when paperwork is determined to be late, an e-mail will be sent out to the Social Worker and/or Nurse and a copy will be placed in their personnel file. The e-mail will state that there is late paperwork and designate if it is the first or second warning. If there continues to be late paperwork after the second warning there will be a written disciplinary counseling that could lead to terrmination (YIKES). While I have noticed I'm a lot more calmer than I used to be and I no longer feel a strong urge to rip somebody's head off their neck in a fit of anger (Thank God!) since being placed on the Adderrall XR, I still am struggling with distraction issues/focus issues/depression issues and I fear I'm going to be written up and terminated no matter how hard I try to meet the agency's paperwork guidelines. However, I don't know if I want to continue to "live, eat and breath" this job, which is what I've been doing and what it takes of me (requires of me) with the way things are. One of the social workers who works with me just quit without even having another job lined up because she told me she tried to choke herself from the stress of it all (she has ADD and she told me she just couldn't take it any longer). I've worked at this agency for more than 2 1/2 years and my job is one in which my"office" is basically my car as I visit clients inside their homes. Needless to say, my car is a disorganized mess (as is my house!!!!) and I have piles of "stuff" wherever I go. I have to drive all over to various counties as they never replaced the full-time Social Worker who quit in Marshalltown, Iowa, several months ago and I'm currently having female health issues that have been causing me problems (in addition to dealing with surviving the daily rigors of life with having undiagnosed ADHD for 43 years). Since I'm new to dealing with ADHD, I'm open to any advice. Part of me wonders if this is a good environment for a person with ADHD to be in (the agency itself has a 38 percent turnover rate) yet I hate the thought of starting over, especially since my short-term memory seems so poor and my mind seems so scattered. Meanwhile, my physical health is starting to unravel and I'm exhausted and isolating myself in order to get my paperwork done (with the exception of this past week, which I took off for health reasons but I'm still isolating myself before the Social Worker (who states she tried to choke herself from all the stress) leaves on 10/13/09. It feels like having ADHD is like having a friggin' LIFE SENTENCE!!!! AAAAUUUUUUGGGGHHHHHHHHH!!!!! Please tell me things will get better! Thanks for listening and I'll greatly appreciate any advice! Sincererly, Penni

[spacecatpj]

OOPS! I meant to send that as an e-mail!

[spacecatpj]

J.P.,

I'm so thankful you e-mailed me and I'm so floored by how much we have in common! Just reading your response to my blog brought me such a huge sense of peace and relief because I can tell you know what I'm talking about. I would love to hear any and all of your experiences that you'd be willing to share with me, especially concerning any experiences you've had with disclosure. I ended up disclosing to my Supervisor and Administrator that I likely have ADHD because my memory has been so impaired and I've been so distracted, disorganized, exhausted and irritable with management that my Psychiatrist signed FMLA papers stating I needed to be take some time off work (approximately a month) for health reasons. As of today, I feel like my mind and memory are so impaired that it's a huge struggle to even find the words to type this or try to explain or describe my situation. I have bought some books on Adult ADHD but I haven't had a chance to really read any of them thoroughly yet because my mind is too overwhelmed to retain any of it. It's hard to explain but I feel like my mind is numb or my thought-process is numb or in a stupor at this moment. I'm also beginning to wonder whether I have fibromyalgia because my muscles and bones feel as if they ache, especially in my legs and pelvic region (and back). In addition to my Psychiatrist appointments (who I'm a relatively new client to him) , I have upcoming appointments with my Primary Care Physician and to meet with a Cognitive Behavioral Psychologist for the first time. I was told the Psychologist has a lot of experience working with adults who have ADD/ADHD. I know this looks like a big huge blob of words without a lot of organization (no paragraphs), but I just had to let you know how much I appreciate you reaching out to me and I eagerly look forward to talking with you. - Penni

[JP (Judy)]

Penni, a chill went through my whole body when I began to read your situation. I'm older than you, by a good bit, but we have a LOT in common. I'm going to reserve going into all the details for now because I want to really reply with solid information that would be beneficial to you, and that may take some quiet thought on my part.

I'll begin by saying that I am also a licensed social worker with a Masters Degree, who most recently, after a long SW career, worked as a medical social worker with a privately-owned home health agency. I totally feel your situation even though I left the agency nearly 3 years ago - shortly after my medical records and other "documentation overwhelm" pretty much robbed me of my previously-high spiritedness but led me to explore "what's wrong with me?" and untimately discovering my ADHD diagnosis! Combined with the unique work environment and stringent requirements inherent in home health, the paperwork issues became a monster waiting outside my door. Believe me, I came to realize that, ADHD or not, social workers are presented with some real identity challenges in that field. I'm sure you know that - as HH is NOT a social work driven service.

Now you know a little about me. I hope that via ongoing communications, some of my experiences can help you think through your situation. This is an important time for you, as you are young (to me - I'm 65) and I'm sure you can't retire, as I chose to do. Somehow you WILL be able to resolve this
situation - with lots of support from all of us. We welcome you to this community and know that, with your skills and experiences, you'll also help US to grow and learn.

Regarding disclosure: read as much as you can about the pros and cons of disclosing your ADHD diagnosis to your employer. It truly is an important decision. Only you can know what's best in your situation but you need to make an informed decision. If you're interested, I'll be happy to share with you my experience. Just remember - we all respond to each other from our own perspective.

I also ran across a values tool online - link attached - that may be useful in assessing your job satisfaction and planning your future in accordance with your skills, talents, and values.

http://career.asu.edu/S/CareerPlan/SelfDiscovery/ValuesAssessment.htm

Areas I'm intimately familiar with: working out of your car, documentation overwhelm, scattered existence, "messes" everywhere, briefcases stuffed with papers, tons of resource materials, memos, charts, forms, seminar announcements (who's going to be allowed to attend - MUST have someone covering for those who do), bits and pieces of "mixed messages" from administration that relate to RNs, PTs, OTs, but with unclear information relative to SW, "this week's procedure" for documenting MD orders, lack of adminstrative/secretarial assistance, tote bags of things you intend to catch up on at home, late night efforts but bags repacked next day with little completed at home, same thing tomorrow, and next week, chart reviews, fear of discovery, waiting for the other shoe to drop, having no influence on policy/procedures, and lots more!!

There is a peace out there though, Penni, and the more you discover about yourself, the closer you'll get to finding it!

[DANA]

Hello Penni!

You are so fortunate to have a psychiatrist who is willing to increase the dosage of your medication when she/he feels that it is necessary. My psychiatrist is so conservative and she refuses to increase my regular Adderall. I am happy to hear that your new dosage of Adderall XR has been increased!

Have you considered keeping a log or journal of your medication and symptoms to determine how well this dosage is working for you? To make it simple, just place a date and any positive or negative symptoms/side effects that begin to stand out to you. For instance, if you notice that you can not sleep at night and it has become worse, it is a good idea to jot this down with the date to see how long this negative side effect continues. Or if you are responding much better with focusing and memory, keep track of the date and information because at a later time, this information may become extremely helpful.

In your post up above you wrote, "Since being placed on the Adderrall XR, I still am struggling with distraction issues/focus issues/depression issues and I fear I'm going to be written up and terminated no matter how hard I try to meet the agency's paperwork guidelines."

I have a few questions:

1) Are you taking medication for anxiety or depression? If not, perhaps inquiring about this could help eliminate the negative symptoms? If you are taking medication for anxiety or depression, is there a possibility that the medication dose needs changed or you should switch to another one?

2) Does your supervisor know that you have ADHD and/or depression? This is a very private and sensitive subject in the workplace. There are pro's and con's to sharing this confidential information at the workplace. If you did not share this with your boss, I do understand. However, if you do share this with your boss, there are accommodations available for individuals with this diagnosis.

3) Is your supervisor taking advantage of you and having unrealistic expectations of you? It sounds like your boss is having you take on the responsibilities of the full-time gal who quit. Obviously, she was stressed out over this job, too. If your boss is forcing you to take on your own responsibilities, plus the full-time responsibilities than she is overstepping her boundaries with you.
In reality, you are one person and you are human, not a super woman. It is too stressful to have to take on MORE than your share of responsibilities. I suggest that you take a good look at all the duties that this supervisor is expecting you to complete in a designated time period and to discuss this confidentially with the supervisor or the individual above her.

Most importantly, Penni, I want to encourage you to begin taking better care of yourself and your health. If there is a present female condition that is a concern to you, trust your instinct and immediately schedule an appointment. As a female, I understand how we are having to deal with so many different issues in life trying to juggle home, work, kids, relationships, finances and our health. Having ADD/ADHD does promote much more stress, chaos and challenges!

Yet, we have to force ourselves to stop everything and take better care of ourselves. Without good health, we are in a more vulnerable position. Taking care of ourselves is vital to leading a more productive and satisfying life.

The bottom line is this, if we avoid taking good care of our health, every other area in our life will suffer. If our health begins to suffer, we will not be equipped to cope with all of the responsibilities at home, at work and in relationships. We can not realistically give our all if we are not feeling well physically or mentally.

My suggestion is that you schedule an appointment with your doctor and discuss your female concerns to receive the medical attention and treatment that will help you to feel better. In addition, consider locating a therapist of professional who you could talk with about the stress in your life, the ADHD issues and how to manage ADHD.

Last, I want to mention that there is an adult CHADD group that is very helpful in educating ADDer's about everything involving ADHD, work, medication, relationships and so forth. It is a very helpful resource that is very beneficial to adults who truly want to learn more and who are interested in connecting with other adults that have been diagnosed with ADD/ADHD. To find your local CHADD group, use your computer and go to this link:

http://www.chadd.org/AM/Template.cfm?Section=Especially_For_Adults

Penni, I pray that you are able to receive immediate medical attention to address your female issue. Once this medical issue is addressed and treated, you will probably be feeling so much better! Take time for yourself because you truly deserve it! Best wishes!

[Michelle MacGregor]

Penni, you need to have your hormone balances looked at and tested. It is possible that you are perimenopausal and that the hormones are affecting your memory function as well. I found that menopause definitely took my ADD from unrecognizable as such to almost non-functioning. It is what drove me to diagnosis really. I too had suffered from depression, but I know now that a lot of it had to do with the symptoms and things I had done as a result of low impulse control - thank you ADD!

Also, your psychiatrist should be able to help you with some supplements and maybe an exercise regime to aid in the ADD management.

As for your job, I would report to your job now that you have ADD. This is a disability under the ADA, jobs are required to make accommodations - and if you do not report they cannot, so it will be no defense if they fire you. But, if you tell them you have ADD - and certify it with your psychiatrist, and they still fire you for something that is the result of your disability. You might be provided with a laptop that you take with you to each site and record the paperwork electronically, or you might be able to record your sessions and your visits and then have them transcribed or put through the a voice recognition program.

For the car, I would really either try to develop a habit of using a PDA or a small laptop computer. It has been a life saver for me, to have everything on a computer. I back it up to a hard drive and I am sure that they could provide a secure place for you to store the laptop and to back up the information. I don't know, that may not be workable, but I have recently just switched absolutely everything to my pda backed up to my computer and it is working really well. I place tasks on the task list and due dates and appointments on the calendar. At the beginning of the day I can look at my agenda and reminders pop up whenever I need them. I also use Google mail and calendar which are synced to my laptop for all of those things. Without this I would never manage all that has to be done!

[Riri]

Dear Penni,

In order to be free from the life sentence of ADD is that you should recognise it first. It is good that you have seen a doctor to make amend to your life. But, in addition to that, you also need to educate yourself more about ADD (well, actually, you are on your way to educating yourself by joining this social network). Have you read some books about it? Those books will give you more insights about what ADD is.

Second, about the job. Your story about your colleague is so similar to my own. I also recently resigned from my current job (starting next year) without having another job in line. The reason? I just can't stand it any more. But maybe there is a difference. I've been working here for 11 years with zero chance of expanding my career. It makes every sense if I got bored, right? Also, I have a plan to change profession which I feel more suitable for me. It's just that I don't know where to start (hehe). When it comes to job, it's important to ask this question: do I like this job? If you do like what you do but somehow you are overwhelmed, then maybe it is the place that is not so accommodating. You can continue what you do, but perhaps you need to move to a different organisation or self-employed. You know better about the situation in your own country, so explore more.

Lastly, in my opinion, the important step to deal with life is to accept your ADD. I don't know if you have reached this stage, but from your post, I think you are still frustrated by it. If you haven't don't be discouraged. It took a while to get there and no one said it's going to be easy. I just recently celebrate my 1st anniversary of being an ADDer, and it is only now I feel a better about and make a some progress. So, take your time, and remember that everyone has her own timing. Give yourself a chance and give your ADD a chance. After all, it is part of you.

I hope my wisdom (ha!) acceptable for you and yes, things will get better!

[brian]

Hi Penni,

We are the same age but I was diagnosed over 10 years ago. It's quite an experience being diagnosed a little later in life than the kids of today being diagnosed before some of them can read or write. This wonderful site did not exist when I was first trying to get a handle on what to do next after getting the diagnosis so there were many many years of trial and error.

I work in a computer engineering company and they thrive on reports (go figure) so I too have had to struggle with not falling behind while the work load only increased. One of the most important things I found that worked for me for was to establish a habit of handling the paperwork and then stick to it no matter what. That is really a two-part step, finding a habit (in your case filing reports) that works would be the first part. Some people save up all the paperwork for the end of the day, others will do it as soon as they finish a task and some will do it based on the time of day (all the morning work vs afternoon/evening). I'm a procrastinator by nature so if I give myself wiggle room to put off getting something done until later, I'll take that opportunity every time so I handle the reports and paperwork as soon as I finish the work. Not knowing the full nature of your job, that might not be possible but this is what I've found works for me. Once I realized this, part two kicked in, stick to this habit no matter what. It takes 21 days to create a habit and once that habit is in place, it allows me to function without the stress of having to remember everything because it's subconsciously on my "to-do list". Of course there are times when I have to be flexible to unforeseen circumstances at work but for the most part, I am able to get right back on track with little effort because it is now a habit. The "no matter what" part to me means being aware of other activities that try to throw me out of the habit, whether it is me getting distracted or others trying to dictate my time. Usually just being aware that this is happening is enough for me to refocus on what is really important and handle the distractions or the requests from other people accordingly. Obviously your situation will be unique to you but this is what has worked for me.

Also, keeping a daily task list in front of me all the time has made a huge difference in my productivity. I'm always amazed how really important tasks would have been late or missed altogether because I totally forgot about them until I glanced at my list. It also feels great to check off the items as they are completed and it is a written record of what you accomplished because I tend to forget all of the things I can actually get done in one day.

One last thing, even though sometimes it feels like it is impossible, is I need to stay organized. Not everything, just the work space.....not the whole desk (or in your case the car) but the area where I do my work. In my case, it's the area in front of my keyboard, it must stay clean and organized or I'll go into brain-lock. The rest of my desk can be out of control, I'll still know where everything is but I need that uncluttered space. Perhaps you could have a briefcase to keep all of your papers in and that would be all that you need to keep organized. The rest of the car can stay the way it is but you'll always know that there is no chaos inside the briefcase. For me it's like a safety zone, a little oasis of peace so my mind only needs to worry about the work and not the mess.

Anyways, I'm running on and on but I hope this helps. There are no cookie-cutter solutions but sometimes you'll find one that's close enough. Best of luck!!

brian