Adderall withdrawal?

My ADHD husband and I split two months ago, after he flew into a rage one day in early August and left. We had been having serious trouble for about three years, and had been in marriage counseling. He had been taking Wellbutrin for about a year and Adderall for about six months at that point, a 10mg dose twice a day. I didn't really dig into it in August or over the last two months, which have been a nightmare of custody battles and legal wrangling that pretty much wiped us out. But we settled, and for the past two weeks haven't had much contact with each other. The drop-offs/pickups for the kids are at school, so we don't see or talk to each other. My contention all along has been that he's mildly bipolar II as well as being ADHD. He's obviously always been ADHD, but about three years ago started to cycle through depressions and then rages about every 4-5 days.

Anyway, he has seemed suspiciously "together" the past two weeks, at least via Facebook and other reporting (he says he's close to getting a job, he switched rooms with the kids, he made soup for them, he signed up to be a class parent, had a dinner party and things like that). I had a moment of regret, and then I thought, you know, it's far more likely that he's temporarily hypomanic than that they suddenly got his shit together. I wonder if he went off his meds? So I poked around a bit and found that the last time he filled his adderall was July 2, which was also the last time he saw his psychiatrist. The pills would have run out at the beginning of August. His meltdown was August 9. Was it withdrawal? He never mentioned that the doc was going to put him on a different medicine. No other amphetamine was filled. He hasn't seen any other doctors, at least ones that bill the insurance and he doesn't have $400 to shell out in cash for an appointment. I wonder if this whole two months of hell was just because he went cold turkey, and it spun him back into his mood disorder. And if it was, why? 

I really want to know why he doesn't know he has a problem? Why would he let his marriage end, almost lose his children and bankrupt the family -- and not do anything about it? If he did, indeed, stop taking the meds in August, wouldn't a person's first thought be, as he drove away from his family, hey, I wonder why this is happening? Maybe it's because I stopped taking a very powerful drug that I need to get anything done and so I don't scream at people? And as the horror progressed, why did he do nothing about it? And now, he probably thinks, wow, I feel great. But there's always a down to his highs. After 10 years together, I can see them coming. 

I can't turn back the clock, but if there is a down coming, I worry about his visitations with the kids. He has them nearly half the time, and I fear what's going to happen if he does get a job, and has to juggle real life like a regular person. 

Has anyone who has been through this with an ADHDer who just goes off meds got any thoughts on what the progression might be? If I have to go back to court, I will. But I don't have anything I can prove right now. I can't tell the judge, "I know he's off his meds because he made soup." Although, I bet all of you here can recognize that as a symptom. 

-allsplitup

My husband doesn't take his

My husband doesn't take his meds regularly. He just doesn't want to be dependent on anything. He hates it that he has to have medication to make himself "work" into the real world. Why is it such a big deal when it has positive effects? That's what I want to know. Why refuse to take it when you know it makes you more attentive to me, to school, to life in general? It doesn't make him different it makes him better. But try telling him that!

Most likely, you are right. The down is coming. My uncle is Bi-Polar. He was a college professor, pHd, and everything. One day he snapped and he had to take early retirement and is now on disability. Too much brain perhaps! He'll go for months and be fine. He went back to school to learn about computers, was taking in computers to fix, etc. And then--nothing. He disappears for days and the only way that my family knows he is alive is because he lives across the street from my dad (his brother).

I would just keep a close eye on him and don't grieve over what happened. If he's truly unstable, if it wasn't this time, it would be another time. Just worry about your kids.

Best of luck to you.

It is possible that this

It is possible that this moment was induced by an Adderall withdrawl, though it could be other factors, too. My ex once had to withdrawl from Adderall because the state ran out of supply. He was off it for nearly several days and missed an entire week of work due to depression and lack of motivation. He didn't want to be around me or anyone else. He retreated to his apartment and didn't speak to anyone until he got his prescription refilled. Though he wasn't filled with anger/rage, one could barely speak with him during this time. 

That said, he would often have manic bouts of productivity while off the meds. Every week, he'd have a new self-improvement idea that would ultimately fall by the wayside. He was great at coming up with ideas but terrible about following through. If he had Facebook, I'm sure he would have posted all of these ideas. Facebook is a great way to seem like you're doing all these great and meaningful things, even if you aren't. Just because he signed up for a class doesn't mean he will follow through, remember. 

I'm not sure if any of this helps, but it seems to me that you made the right decision given what you've written. No looking back now.

WD

I hate to be disagreeable, but there should never (almost never) be any profound physical Adderall withdrawl, assuming a person is using it as directed.  One of the things that makes Adderall such a good and safe drug is because it's half-life is quite short, which means that it does not remain in your body in an active form for very long.  My therapist told me that some people who suffer some of the negative side effects of Adderall (thankfully I do not) go on drug free weekends when they do not need help with organization.  So if that is an accepted practice then it further backs up my own experience of never experiencing w/d when I forget to refill my rx.  Adderall is a pretty ideal drug for adults that get benefit from it, in my personal experience.

The only time that w/d would be physically noticeable is if a person was abusing Adderall.  In this case the dosage and rout serves to add a euphoric effect (I am told) to usage and anytime you are triggering too much pleasure your body is going to rebound harshly.

Other unwelcome feelings that some people feel after not taking their Adderall for a while are likely just the impact of not being medicated, and perhaps additional depression stemming from the fact that you are unable to perform at your "normal" medicated level.  Thus it is not really w/d as it has nothing to do with any rebound effects from the drug itself.

Note: I am an RN, but nothing I say should be taken as medical advice in any way.  I mean only to share information I have gleaned from research and from asking my therapist.  

 

RE: Original poster- You likely made the right call.  I get cranky, short, and intolerable to be around when I have not taken my Cymbalta on time (I hate this drug in a lot of ways, but it does help quite a bit), but it is still me being a jerk, not the drug.  So even if there were significant w/d effects from Adderall it would not excuse poor behavior, and since w/d is ruled out there is nothing for him to hide behind.  

Adderall and emotions

I am also not a doctor, so see your doctor if you have specific questions about how Adderall affects you.  Here's what I do know.  Adderall goes in and out of your system quickly.  Some parents report that their kids on Adderall have a "witching hour" around 3 or 4pm when the medications wear off - a time when they are more emotional (typically more cranky) and sensitive.  It makes sense that adults might well have the same thing (though don't have someone "watching" them at baseball practice to report on it!)

One of the side effects of Adderall can be that you become more emotional.  I noticed this in my daughter (now 21) only when she ran out of Adderall or didn't take it on a regular schedule but some people report this as a side effect of taking the medication, while others report it as a side effect of not taking it.  My daughter also reports that if she has been taking the medication regularly for quite a while and then suddenly stops she feels very tired for about 24 hours or so.

Some report that once they've figured out just how much more clarity they have while taking medications, going off the medications because they don't have it (but want to take it) can be extremely depressing.  Suddenly, after feeling more competent and focused, they are once again "fuzzy" and unable to complete things they could otherwise finish.  I suspect this type of depression was what your husband experienced when he went away for a week.

Finally, because Adderall is an amphetamine, too high a dose can cause irritability, anger and tension.  This is not what you reported about, of course, but I thought it worthwhile to include while writing about emotional issues and Adderall.

Hope this helps.

Adderall rebound effect

It is also the case that stimulant use has a well-documented rebound effect, so you will often find  that after they wear off you can be left even more depleted than if you had not taken them in the first place.  One supposes this is due to the brains attempt at self-regulation of Dopamine and Norepinephrine .i.e. when the levels are artificially elevated the system either cuts back on production or increases reuptake, this is followed by a lag/deficiency when they wear off and the body has not yet adjusted its levels to a baseline.    This is why irregular dosing and sudden high dose withdrawal can cause marked emotional instability.  You can guinea pig this effect with high levels of caffeine, with an initial boost of alertness and task performance, followed by a lag when the effect wears off, the same is true of Nicotine. I always found the period of time in the evening horrendous for this reason,  i.e. I was irritable,  more distracted than normal and generally worse, my work got a more focused me, my  family got a more distracted/irritable me.  It is one of the main reasons I don’t take stim meds.  

This lag ought to be reasonably short term (i.e. 1-2 days tops), unless there has been severe overuse/abuse, in which case withdrawal can be severe.   If this is the case then the person will usually sleep and eat a lot during this period as well,   stimulant abuse is very easy to spot and hard to get away with unobserved.  

Not all stimulants are the same

I would be interested in where Adderall use within proscribed limits has been "well documented" to cause rebound when stopped.  Caffeine and Nicotine withdrawal data should not be used to indicate anything about Adderall, especially use that is within safe proscribed limits.  I do not discount the idea that there is data that I have not read, and if there is such data about Adderall then I would like to read it so I can be fully informed, but I have not seen such data from a reliable source personally. 

Same site of action, so broadly similar.

Adderall is nothing special,  just a a mix of amphetamine salts.     Nearly all stimulants that act on the Dopamine/Norepinepherine receptors have this effect,  and there is nothing in Adderall that would make it act any differently,  it as I said a well known effect .  

http://www.ncbi.nlm.nih.gov/pubmed/18294083 

provides an extract, however a simple google search will turn up a lot of information. 

Even wiki has a section on rebound related to ADHD meds, not that I would consider that at all authoritative. 

Withdrawal is not the same as rebound, although there is rebound effects in withdrawal.   Rebound occurs in many types of medications that work as neurotransmitters or reuptake inhibitors etc.    Also you ever notice how pseudoephedrine  clears your nose but then it comes back more blocked that before? That's an example of rebound effect. 

Of course not everyone is going to find this effect noticeable,  and some are going to be more sensitive than others. 

For me Dex made me crash and burn every night,  I went from functional to wanting to slash my wrists....metaphoricaly speaking. 

 

 

Thanks for the reply. I think

Thanks for the reply. I think I got a little carried away with worry because of that nanny in NY who murdered the kids, and I have heard of a couple of other suicides recently. People just snap, and it's scary. And you never know. It's one thing to move on with my life and not take responsibility for him ruining his, it's another to think that I'm ignoring some serious warning signs that could lead to disaster for him or my children. I never know if I'm over-reacting or not, because it's only possible to see how "off" he is when you are living with him. If you only see him once in a while, or only read his Facebook posts, he seems like a relatively normal person. Because he hasn't worked in so long, nobody sees him on a daily basis (now, not even the kids), so he never has to hold it together for very long. But I had plenty of days with him where I was afraid to leave him alone because I feared he'd hurt himself, and other days where I had an emergency plan in my head if his rage turned violent and I had to flee with the kids.

With somebody who swings to and fro so much, and you don't know if it's just ADHD or its bipolar disorder, or something else, how do you know if you're over-reacting? I'm a pretty even-keeled person, who grew up with a very volatile dad, and I never had any thoughts about these things previously. But something about him worries me and scares me. It is an edge of madness I haven't seen before, and I don't know what the depths of it are. Sometimes, I can just gloss over it and say it's all fine.  And other times, I wish he would cross over the edge so he'd end up in a facility and they'd sort out what's wrong with him. I just don't want my kids to get hurt. 

 

I think that if you have a

I think that if you have a sense that something is wrong with your husband's behavior, you should not ignore it.  Do you have a therapist or physician of your own that you could talk to about this?  Good luck.

taking care of myself

Yes, I have a therapist that I've had all along, and she's also convinced that he's bipolar. I have contacted his last psychiatrist, whom he hasn't seen since July, and asked him to call his talk therapist. But since they're not allowed to share medical information with me, I don't know if they connected.  I've had friends talk with him, and have had people reach out to his relatives, but he denies anything is wrong with him. I have also consulted a therapist for the kids, but need his approval for them to see her, and he's in no mood for that. 

some thoughts

Dear allsplitup,

I have become aware of how delicate brain chemistry is over the years, watching my spouse and the effect that various medications have had on him. BTW, he once decided to stop taking his adderall cold turkey without telling me, as he was getting insomnia, and ended up unable to get out of bed for five days. It was awesome--right in the middle of Christmas vacation with preschoolers. I said, "Hey, should you talk to your doctor, or possibly go off of it slowly?" His answer, "I can't do it that way!" I am sure that changing, going off, or altering meds can have a significant effect on just about anyone, and my DH himself seems extremely sensitive to medication. He tried another med last year for an unrelated condition and it made him so manic I almost had to call someone to come over and manhandle him into a car to see a doctor. I think mine is mildly bipolar as well. 

And I am sorry--to answer your question from my perspective: I am sure your husband does know deep down that he has a problem. I believe that like anyone with an addiction or mental illness or any issue that can negatively affect his or her own life--this is very powerful. The very wherewithall that is needed to address something this powerful and take steps to manage it is hard to summon up and maintain, for a variety of reasons. It is sad, but it speaks to how powerful it really is that a person would lose his or her family, or income, or home and still not be able to address it. Some folks eventually can, and some can't. Some need to hit rock bottom, and then accept that the issue will always be with them, but that they can manage it and their own quality of life if they choose. They have to do it for themselves, and they have to want to. 

As someone who is slowly going through the process of emotionally separating, with plans (pointedly now getting my ducks in a row) to physically separate, my thoughts are with you as you navigate this. My therapist was incredibly helpful when I was worried about my husband saying negative things about me to our children (and others). Unfortunately, this is something he does when angry or upset--he has done it for years, and I imagine him saying "Your mother is making me move out and leave you.." "Your mother is mean," etc. as this goes down. I still have a hard time believing that a father would do that and not worry about the effect it may have on his kids--my golden rule, no matter what, is that I would never, ever trash him or say anything negative about him to our kids, because it would be bad for them. But he can't seem to help himself, even though I know that he knows deep down that it is not a good thing to do. 

My amazing therapist told me the truth: it may happen, and I can't control it, and my children, when they are older, will see that I behaved in loving, respectful, calm way (hopefully) and that they will be ok. You can't control what your husband does, although, if he starts behaving in a detrimental, abusive, or harmful way toward your children, you can, I am sure, address this and limit his custody further, right? The most important thing you can do is provide a safe, calm, loving atmosphere for your children and look out for their best interests. 

As for your husband's posts on Facebook, I don't know what you can make of them. I have seen that my own has a huge need to "show" that he is a great, wonderful guy who is in the right and is doing really well after a setback. Could yours be publicly writing about how well he is doing to make himself feel better after losing his family and having to move out? 

And, I would write everything down. Can you get the advice of a legal person so that you know what to look for if you need to protect your children? 

He's So Fine

I have seen that my own "DH" has a huge need to "show" that he is a great, wonderful guy who is in the right

Lynninny, That is THE major trait of my DH.  He was in sales.  Every interaction with everyone is a sales pitch to get people to like him. And he would feel PERSONALLY depressed if he lost a sale.  His agenda is all about being likable with his kids and family members.  No teaching, parenting, problem solving, introspection.....just "Aren't I amusing and likable?" And he is not afraid to call names and talk bad about people who do not agree with him.  So, at a distance, you like this guy unless you have to be in a joint venture with him because he will be M.I.A. and he will think he is cleverly getting out of doing what is expected of him and on his way to get other people to like him while you are holding down the fort. 

Allspslitup, Why would he let his marriage end, almost lose his children and bankrupt the family -- and not do anything about it? This is the nugget of the problem those of us nonAdders go crazy about.  This is what we scream, rant, remind, try to support, encourage, try to get attention, everything we can think of to get the attention that they are losing their family and they don't do anything but distract themselves from the problem.  They can't?  

Why do I write these things over and over?  I guess it is because I have stuffed so much for so long that I am still trying to accept its reality.  Until I can name it and accept it, I am unable to do anything about it.  Why is this so hard to accept and do something about?

Not a good answer...

QUOTES:

Allspslitup, Why would he let his marriage end, almost lose his children and bankrupt the family -- and not do anything about it?

Why do I write these things over and over?  I guess it is because I have stuffed so much for so long that I am still trying to accept its reality.  Until I can name it and accept it, I am unable to do anything about it.  Why is this so hard to accept and do something about?

 

This is probably not what you want to hear, but it is very hard to put in to words the powerlessness and futility we feel when we are suffering without support (be that pharma and/or therapy).  It is also highly individualized.  I know one of my big problems is that I feel like I have had to ask for help so much in my life (financially mostly, but also in other ways) that it is demoralizing when I have to get more assistance from people that have already given me so much.  I feel like  a leech, and that fear of facing my continuing dependency makes me try and "deal with it" myself sometimes.  Now, I have a pretty open relationship with my wife and she is somewhat on-board with helping me know when I need to ask for help, but I still get that reticence regularly.

I don't have an solution for you as to what to do, but maybe this gives you some small insight in to our chaotic, self centered, thinking. 

For drworm: I just read your

For drworm:

I just read your reply and I have a question for you. My ADHD hubby often struggles with feeling powerless as well. He said this morning that he felt like he was leaching off of me, etc.

My question is: why can't you shake yourself out of it? I, for one, want to resolve negative feelings immediately. I hate feeling out-of-sorts. If I felt like a leach, I would be doing everything in my power to fix it. Yet, it appears that my hubby does not. He chases rainbows the moment they appear and is distracted from the things that really matter. Right now, for instance, he's in school. He started with four classes and is now down to one. Two of the classes were dropped because he was failing, the other he felt he would fail so he dropped it too. We're now faced with him losing his financial aid. I don't understand how he could let this happen. He can sit all day and talk about the importance of getting his degree, but when it comes to actually doing well at it, he falls apart. If getting a degree was my one hope for getting a better job (because I hate what I have been doing), I'm going to be busting my tail to make good grades and to get it done. But he doesn't. It makes no sense to me at all.