A cautionary word about ADD meds: Stimulants can be very problematic for those with bipolar. Thus, in co-occurring bipolar-ADD, Dr Parker recommends addressing the mood disorder first. According to Dr Parker:
If stimulants and antidepressants can dysregulate the bipolar brain, start by correcting the cracks in the bipolar foundation first. ... Address ADHD only in sequence, after significant moods are successfully managed. Think emotions first, cognition last.
Dr Parker also cautions that a number of mood stabilizers (he specifically mentions Depakote) block the 2D6 metabolic pathway traveled by amphetamines. The backed-up stimulants may result in unpredictable moods.
Finally, the black box warning: I am not a medical doctor or a clinician, and I cannot claim to have even lay knowledge of ADD. Moreover - as this series has made abundantly clear - true expert knowledge regarding the bipolar-ADD overlap is sorely lacking. Accordingly, the best expert about yourself is yourself. So, from one “expert” to another:
- Read up on ADD. Gina Pera’s book offers very descriptive non-clinical real-world accounts. Eileen Bailey here at HealthCentral is also required reading. along with her book, “The Complete Idiot’s Guide to Adult ADHD.”
- Feel free to consult the DSM as a rough guide. Also, a commonly used six-question self-screening test can be found online. Keep in mind, you are simply asking yourself questions, not performing a do-it-yourself diagnosis
- Consult with friends, family, loved ones. The people around you have far better awareness of what makes you drive others nuts than you do. Resist your natural urge to throw up your shield walls, and listen with an open mind.
- When consulting a psychiatrist: Beware of their tendency to default to the bipolar diagnosis. You may have to shop around before you find someone who is proficient in recognizing and treating both bipolar and ADD.
- If you are in family therapy: Gina Pera cautions that family therapists are notorious for failing to recognize ADD as the third party in the room. Blame is rampant, progress is nonexistent. The ADD - if you have it - needs to be addressed in relationships.
- Your bipolar recovery tools will be helpful for ADD, but expect to make modifications and adjustments. New challenges demand new strategies.
- Recovery is possible. Your brain is plastic and is changing as you are reading this. We may not have been born with optimal thinking machines, but with effort we can make our own.
Be wise, live well ...
This concludes (for now) our series on the bipolar-ADD/ADHD overlap. Many thanks to community member David, who, in a comment, pointed me to Dr Parker. Also, many thanks all those who commented, which helped me enormously.