Doctors Lounge - Psychiatry Answers
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Forum Name: Psychiatric Topics
|smyrna - Sun Sep 30, 2007 8:30 am|
Hello, and thanks for reading this.
To start off with, I'm a 23 year old male in good overall health. 5'10", 135lbs, smoker but trying to quit. Not currently on any medication but I tried Adderall with mixed results for a couple months. My only significant medical event is Hemolytic Uremic Syndrome when I was about 4 years old, due to eating undercooked beef infected with E.coli.
After failing out of college in 2004, I've worked a number of crappy, unskilled jobs. I want to go to a 1- or 2-year trade school but I know if I go, it will just be a repeat experience of high school and college. I simply can't make myself sit down and do homework or study unless it's something I'm very interested in, and even if I am very interested in something I'm prone to be sick of it after a month.
I know I'll never get ahead financially if I don't get somewhat of an education and get a well paying job. I'm fed up with the endless repetition of factory work, the constant acting of customer service jobs, and the degrading custodial positions. But if I don't get out of this rut I'm going to be stuck doing that kind of stuff for the rest of my life, and it'll take me 10 years to get out of debt, if at all. I'm terrible at budgeting, I impulse spend, and I didn't even file for my last 2 tax returns even though I'm owed over a thousand dollars because I just didn't want to.
I've known that there's something "wrong" with me ever since I can remember. But I like who I am and don't want to change, so I never looked into it. But lately I've been trying to see what I have to do to be self sufficient and it all comes down to the fact that I need to get motivated, organized, and at least get a plan together for the next 5 years. I've come to accept that I can't do that on my own.
I started researching things, and at first I thought I was depressed, but that doesn't really jive with me. I don't feel inadequate, dumb, or worthless. I've never wanted to hurt myself or others. In fact, I have a good amount of self-confidence, I feel I'm attractive and overall a good person.
I don't take much stock in self-diagnosing, but when I came across Schizoid Personality Disorder my mind was pretty blown. It was like reading some sort of study that someone did on me. I don't take kindly to the phrase "personality disorder" because, like I said, I don't consider myself "broken" and in need of fixing. But there's just the fact that I won't do anything to improve my lifestyle unless I get help in some way with it.
I can't really organize my thoughts well, so I am just going to copy some of the diagnostic criteria and my thoughts on it:
- Neither desires nor enjoys close relationships, including being part of a family
Any friends I've had have been superficial. I've never had a close or "best" friend, only people to joke around with during lunch hour, etc. I have a good relationship with my family but I don't consider myself close to them, and in fact would not miss them or anyone if I moved far away. Any activity I might enjoy would be ruined by the presence of friends, family, or really anyone.
- Almost always chooses solitary activities
I never liked sports, games, etc. I have my own hobby at any given time (it changes quite often) and none of them require others. I spend time by researching whatever topic it is that interests me, and that time would be ruined if there's other people around to distract me with questions, conversation, etc. If I have a hobby that requires actually doing something I'll lose all interest if someone else interferes.
- Has little, if any, interest in having sexual experiences with another person
Although I want and enjoy sex, my experience with relationships has put me off the idea of really pursuing it. I've had a few intimate relationships and none of them ended well. My paradox is that if there's someone I'm very sexually attracted to, to the point of pursuing it, I will inevitably get too emotionally attached. However, that same emotional involvement on the part of my partner drives me away. Yet I still feel jealous and hurt if she doesn't really care about me. My first serious long-term relationship was a constant battle because she always wanted to know what I felt and what I wanted to do, and couldn't accept "nothing" as an answer to either question.
- Takes pleasure in few, if any, activities
The only things that makes me really feel any pleasure (or pain) are alcohol and sex. And of course that's only in a purely physical sense. I used to abuse alcohol pretty heavily, I think because only with booze could I feel any kind of emotions, but I've gotten over that. I now only drink on my days off after getting errands done, because I can't even watch a movie or T.V. show without getting bored and distracted. Overall I'm pretty sick of alcohol. I used to smoke pot but I don't have any friends to get it from, and plus I have a greater respect for the law these days, so unless it became legal and cheap, my pot-smoking days are over.
- Lacks close friends or confidants other than first-degree relatives
I pretty much covered this above. Don't have 'em, don't want 'em.
- Appears indifferent to the praise or criticism of others
I do very well at whatever job I happen to have at the time, so my supervisors tend to give me lots of praise. But it doesn't mean anything to me whatsoever. I just do what I do and that's it. Just leave me alone so I can do it. Any time I've received a raise I just don't even care. Maybe if they doubled my wage I would be excited for a moment. Criticism is the same way. Any time I've been criticized I act apropriately outwardly but inside I know it's either a misunderstanding, or, if it's valid criticism on my part, I take it to heart and don't get upset.
- Shows emotional coldness, detachment, or flattened affectivity
I never feel any emotions. Loss of grandparents, pets, significant others, jobs, etc--none of that truly affects me. The most awkward situation I can be in is if I hear of someone I know losing a loved one because I have no idea how to react. I just have no experience feeling what they are going through. I know if I lost an immediate family member I would be sad and probably cry, but I would get over it quickly. If something positive happens to me, I act happy but inwardly I don't feel any different. This is a good thing because during extremely stressful situations I always act calm and rationally.
Like I said, I don't consider myself to have a personality disorder, everything I've read about it, especially accounts from diagnosed schizoids, just clicks with me like nothing else ever had. I don't want to "fix" it, but I'm willing to do whatever it takes to be able to start my life in earnest. I don't want therapy or counseling, that won't work on me. I think medication is my only option here, but I have no idea what to ask my doctor for and how to ask him for it. I'd rather stay out of the psychiatrist's office, as the last (and only time) I went there I spent half an hour convincing him I wasn't depressed. This is all terribly personal to me and I would never discuss it with anyone, so it's great that this forum gives an anonymous way to seek advice.
Despite how terribly long and boring this is, I'm sure I've left some things out. Any thoughts, advice, etc would be much appreciated.
|smyrna - Sun Sep 30, 2007 8:53 am|
I forgot to add something about my experience with Adderall.
It worked somewhat, but even though I was on the highest dose of XRs it seemed to be not enough. It went a long way towards silencing the internal noise and chatter but I still was too easily distracted when reading and at work, and I felt no particular reason to get the usual errands done (paying bills, doing laundry, cleaning, etc), so they remained undone, as usual.
|Dr. K. Eisele - Sun Sep 30, 2007 3:37 pm|
The thing about self-diagnosis, especially of the personality disorders, is that all of us have traits of all of the personality disorders. I like to think of personality types, instead. For a personality type to be considered a disorder, it must cause significant distress in more than one area (social, interpersonal relationships, occupational, educational) of the individual's life. No distress, no disorder.
It sounds like you have some distress, but don't we all at some time? I think maybe you have a schizoid personality type, and I think that ADHD is a reasonable diagnosis to rule out.
There are many different treatment options for ADHD. You should consider asking about atomoxetine, or Strattera, or even one of the Ritalins. There is also dextroamphetamine (Dexedrine) which is also very effective. Stay away from pemoline, because it can cause very serious side effects, and is very rarely used anymore. Other less common treatments include the antidepressants, bupropion (Wellbutrin) and imipramine (Tofranil). The latter two tend to be less effective, but are sometimes used in combination with one of the stimulants (Dexedrine, Ritalin).
Family practice physicians usually do a fairly good job of diagnosing and treating the attention deficit disorders.
Good luck to you!
|smyrna - Sun Sep 30, 2007 11:09 pm|
Thank you for responding Dr. Eisele. I don't understand what you mean, though. You said that ADHD is a reasonable diagnosis to rule out, but then you went on to describe different ADHD medications. Maybe I misread or misunderstood you :)
I don't mean to self-diagnose. I have very little respect for those who are convinced there is something wrong with them, then look towards the internet to identify with a group. I've seen a lot of people who say they have Asperger's for example, but really are just sheltered and haven't developed any social skills. I don't mean to come off that way at all. I just wanted to give information about how I think and feel. I am not good at talking about myself, so I apologize if I didn't make it clear that this is causing me significant distress in both the occupational and educational areas. Unless I can get a decent education, my prospects occupationally are very dim, and I can't get ahead. The fact that I can't, in the state I am normally in, get a well-paying job is the major problem with my life.
Once again, thank you for reading and responding. Like I said, I'm no good at talking about myself, so I tend to get long-winded and unclear.
|Dr. K. Eisele - Mon Oct 01, 2007 9:56 pm|
I'm sorry, you have been the unfortunate and unsuspecting victim of medical jargon. I do apologize. When doctors say a particular diagnosis would be good to rule out, it means that they think there is a good possibility that the particular diagnosis is correct.
That's why I included all the information about meds for ADHD.
Hope this clears up the confusion.
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