For those who want to skip the novel below which is specific to our case, what are your feelings about medication holidays or taking meds on an 'as needed' basis. Please give me the reason behind your answer because we need to come joint accord with this issue between ADD hubby, I, and his psychiatrist & psychologist.
We are limited in doctor choices in our area by insurance, so that is a factor. I met the original doctor who diagnosed my husband....we actually had a long appt where both of us were asked to participate freely. Quite frankly I liked his original doctor, he seemed to come to the ADD conclusion fairly easily (we'd already done a ton of research too, and he prescribed Ritalin which was changed later to Adderall because of side effects--jaw clenching bad enough that he gave himself headaches, mid afternoon crash, and general jitteryness. None of the side effects were such that Eric ever discussed discontinuing meds because of them. The coach (psychologist) we were provided there was more ADD than my husband and abysmal for actually helping with anything--Eric liked him cause he sympathized with everything and had no expectations of him.....ie "You didn't keep a list of x y or z like I asked you to so that we could decide where you need help first? ha ha I didn't think you'd do it! You do have ADD after all..."
I posted about him at the time before.....just dreadful. Anyway my husband was transferred to a closer clinic about 2 years ago just after the switch to Adderall, and I have never met this psychiatrist, but his coach (the psychologist) called me in to join a session about a year ago and now involves me in his homework though I have not been asked to sit in on other sessions.
About 3 months ago back before our anniversary trip at the end of October, my husband came home from his appt with his psychiatrist (once every 6 months) and asked what I would think of him taking meds only on an 'as needed' basis. Quite frankly I am not a fan. I am also not a fan of weekends off of ADD meds.......if your brain needs an extra chemical, why would you deny it sometimes? My husband heard me out, said he wasn't really tied to the idea either way, but that his doctor seemed to think that since he is mild and functions so well that perhaps he could start thinking of getting off meds.
I tried to be calm but was a bit spooked......why mess with something working so well. I'd assumed his doctor was an ADHD specialist but then Eric said he doesn't think so and that the DR said that it wouldn't hurt anything to get off the meds as most of their effect was PLACEBO!??! I mean what the heck??? His current psychologist, who functions as a coach, is not listed as an ADD specialist, but she has an ADD son and really seems to know her stuff. She assigns great homework for my husband to do between visits and doesn't let him off the hook if he has some lame excuse why he didn't do much with it.
I was completely thrown for a loop and all my research has basically said 'give your brain what it needs and don't mess with holidays etc' so I said it is obviously his decision and I would support what he chose, but x, y, and z are reasons why my understanding is that you stay on meds.
We talked about the options pretty intensely and while Eric didn't seem to feel very emotional about being on meds vs not being on meds, he seemed a little hurt at how anti off meds I was.....as if I was implying by my attitude that he couldn't handle it. Which is ridiculous as he was 35 before he started taking meds and he managed a degree without, BUT things were going so well and smoothly and the balls were mostly being neatly juggled and I am not one to mess with a good thing.
It wasn't until these conversations that I found out the doctor felt that this was the direction we should be moving in ....to meds 'as needed' and then possibly to no meds at all. After this came up Eric said he's always gotten a vibe from this doctor that his ultimate goal would be to take Eric off meds!??!!? He never told me this. From Eric's description, the doctor seems to think the meds are for keeping you on track while you develop tools and tricks to get everything done. Then you get rid of the medicine......like you are cured?? like now you can cope w/o?? I don't know....I don't really understand. I mean we all know ADD is incurable so why doesn't he seem to realize this? This seems very much to me like taking a diabetic off insulin because their blood sugar has been steady...just no sense at all.
Eric saw his coach just after our convos about going 'as needed' or possibly trying no meds at all during 1 week of our 2 week vacation...I was willing but reluctant. The decision they came to was not to risk messing up any part of our anniversary trip (RELIEF) and that sometime in the future if he wanted to experiment with 'as needed' meds he should do so. I don't think she meant on his own when the fancy struck him, but that is how he took it and without informing me or her, he started taking them whenever he felt like it around mid to late November.
I didn't clue in until we'd been having a rough time...Eric was spacey and not like himself. I thought it was delayed reintegration from vacation reaction at first...and Eric didn't seem to have any answers for why he wasn't functioning as well. FINALLY something clicked and I asked about his meds and he told me that he was only taking them when he felt he might need them--amounted to about 2x per week. I was really angry he did something like this with no one monitoring & I was especially angry that the response to "What is going on, babe? Why are you struggling so much? What can I do to help?" Were all met with "I don't know". He claims it never occurred to him that it could be med related because he never feels any different on or off them. He thinks he is accomplishing just as much too regardless of how little he is getting done...maybe because it is the same amount of effort without meds to just think of doing it?? I have no idea.
So shortly after our argument about this, he saw his coach who told him he went about it all the entire wrong way. That he needed to let me in on the schedule so that I would be aware of tracking how he was doing day to day on a meds/no meds basis. She had told him she thought he could try 'as needed' but that he went about it entirely wrongly. Now when she tries to find out how it is working, there is no info at all except a very non self aware ADD person sitting there saying that he thought he was doing well but his wife seemed to think he was dropping the ball.
I have been wondering all along if it was really the doctors pushing this or if it has been Eric, but no matter how subtly I question him, he does not seem to be emotionally tied to taking meds or to being free of them. He was up for seeing how he would do without meds, but now the concern seems to be that he really can't tell a difference on or off. I don't want him to take them just for me, but he is SOOOO much better on that & it isn't that he doesn't believe me when I tell him so, it is just that he has no frame of reference to say "You are right x y and z are much better on meds".
I think this lack of self awareness is part of the reason his doctors don't think the meds matter. Eric had been taking 20mg in the morn for a while, but he was feeling overwhelmed sometimes. So the doctor added an extra 10mg in the afternoon, and when I asked if it helped he said "I don't feel overwhelmed anymore but I don't notice anything different" Like WHAT else are you expecting to notice if it solved your problem?? But the last time he started acting all spacey was because he was adjusting to the doctor taking him off that extra 10mg. I asked why and he said it didn't do anything for him. Umm ok. My husband claims there was very little difference when he stopped taking the extra dose, but I assure you everyone else in his life noticed that he all of a sudden had something diff going on. EVERYONE was asking me what was wrong with him.
So anyway, after reiterating to Eric every point I made about why it was a bad idea to change the med schedule with no one knowing about it, she assigned homework for us both. Eric has a goal of trying to step up and taking control of situations since his natural default is to be passive. Both of us were to keep lists of what he did well at this and what he did badly at this for the month, and both of our report cards were to be given to her at the next appt. The problem I see with this in hindsight is that he's been hit or miss with the med schedule (just found that out he's struggling with not having it as any sort of routine--should have seen that coming) so we couldn't/didn't know to track his accomplishments along side whether he'd taken meds or not.
Interestingly almost all the stuff on Eric's GOOD list, I also had on mine (and I didn't write mine up the night before like he did :BIG EYE ROLL:) though I had many more things than he did. I had about 10 EXCELLENT items. I also had a list of 4 items that I listed as GOOD because he didn't really step up, but when he was asked he jumped on them pretty quickly. But our BAD lists weren't very similar at all. I had another 10 items including the one big argument we had during the month--he hadn't even listed that item. One fight all month because of something he didn't step up on, and he didn't list it on his BAD list??
Anyway the coach when she read through the lists and talked them out things there is a strong correlation between the items on his BAD lists and not having medication steadily in his system. She asked what he thought, and he told her that he honestly can't tell anything but that I certainly can so he doesn't know what to say. She set up an immediate appt with his psychiatrist to evaluate the meds, which was supposed to be today but he forgot and double booked the day, so it is now rescheduled for next Thursday. We have the same assignment for the psychologist for the coming month with the added item that I am putting in whether he took or did not take his pill, BUT the problem is that the meds appt will be before much data is in on this.
What do we do? Do I trust him to handle it even though he seems completely unaware of how much less he accomplishes without meds? Do I ask to meet with the doctor also, or does that look like a controlling mate?
THANK YOU FROM THE BOTTOM OF MY HEART FOR ANY SUGGESTIONS.......actually just for reading the whole thing to anyone who did :)