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Old 06-07-2010, 07:43 PM   #1
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Unhappy Anxiety and hypertension preventing taking medication for my ADHD; what can I do?

Hi all,
I have the unfortunate combination of ADHD, several anxiety disorders (social, generalized, panic, agoraphobia) and hypertension. This is unfortunate because the medications that help ADHD make the anxiety and hypertension worse, whereas the medications that help the anxiety disorders and hypertension make the ADHD worse (and to my knowledge there's no one medication that helps both). I was "officially" diagnosed with the first two when I turned 12 (I'm now 20), and the third is more or less self-diagnosed. (Note: I apologize if this is a bit long, but I tried to include everything so as to give a full understanding to those reading. If you'd rather not read the in-depth descriptions of each issue you can skip to the last paragraph.)

I'll cover the hypertension aspect first: whenever I go in to see a doctor and they take my blood pressure, they comment on how it's high as well as how high my resting heart rate is. I believe this is a result of my anxiety issues; I'm never comfortable in public places and just knowing the fact that my blood pressure is being taken gets me stressed out and anxious which as a result makes it go up. I bought a blood pressure monitor about six months ago to do weekly tests on myself at home...the results have been lower than the results in the doctors offices, but still aren't great. The average of all the tests has been Systolic: 131, Diastolic: 85 and Heart Rate: 93. The highest I've gotten has been 141 over 95 with a heart rate of 109 and the lowest has been 120 over 80 with a heart rate of 79. Both of these were one-time readings though: the systolic is almost always between 125 and 135, the diastolic is almost always in the mid-80s and the heart rate is pretty fluctuating, sometimes in the 80s, sometimes the 90s, and sometimes the low 100s. On the other hand, the readings I've gotten at the doctor's offices are higher, two recent examples being 142 over 103 with a heart rate of 117 and 155 over 92 with a heart rate of 93. In all the tests I've done at home, I've never gotten readings that high, and I've used a few different devices as well so I know it's not the equipment at fault.
I'm also undecided on whether or not I experience "heart palpitations;" I will have periods where I'll be aware of my heart beating and have anxiety about it, but I think it's more of a mental thing, like I'll read a worrisome article online about deaths or illnesses caused by heart problems and then I won't be able to stop focusing on my heartbeat and worrying about how fast it seems to be beating. The same will happen when I'll take a medication which has potential side-effects and I'll worry about whether or not I'm experiencing the side effects or not so much that it will result in an unusual awareness of my heartbeat and an increase in anxiety.
Finally, during exercise or any sort of strenuous activity I'll become short of breath, overheated, dehydrated and exhausted very easily. This would suggest that I'm overweight, but I'm pretty average at 5 foot 7 and 155 pounds. My anxiety issues keep me pretty confined to my house which in turn means I don't get very much daily activity, so this part could just be due to being out of shape rather than a heart thing though.
I did ask my doctor about this and he did some tests and some blood work, with the only abnormality being a vitamin D deficiency. I was given vitamin D capsules to take once a week for 2 months; at the end of the 2 months my blood pressure had gone down a fair amount but it still isn't optimal.

Now for the anxiety issues...it started out as just social anxiety and panic disorder back in middle school/high school, when I'd be extremely shy, couldn't make eye contact with anyone, never talked to people I didn't know and would experience panic attacks whenever I had to do something like a class presentation. Then once I became homeschooled and isolated inside the house without a lot of daily human interaction I eventually began getting anxious and paranoid about other things and began to hate leaving the house, feeling extremely ill at ease whenever in an unfamiliar outside situation or around unfamiliar people. I still have these issues.

And finally the ADHD aspect. Back when I was in school, I would do great if I was actually interested in the material at hand. Creative writing or art assignments would always be a breeze, but boring methodical busywork such as math homework or studying for history tests was absolute torture and I ended up doing poorly in those areas as a result. When I became homeschooled there was a period of about 2 and a half years where I was golden: I only studied or worked on what was interesting to me so my attention was always there, the social aspect was gone so the social anxiety was gone as well, and I excelled in everything I did.
As I said above however, eventually the isolation got to me and my anxiety began to take over in other ways and the ADHD returned once more, this time not just interfering with school work but with absolutely everything I did or attempted. It felt like my mind was full of fog, I couldn't do anything, I couldn't take pleasure in anything, I was always majorly fatigued and unfocused and even things I used to love became a chore to focus on. I believe this reemergence had a lot to do with the medications I was being given: anti-psychotics like Risperdal, Zyprexa and Seroquel and anti-depressants like Paxil, Zoloft and Lexapro. Instead of making things better, these just made me not care about anything, made me constantly tired and made me completely unfocused and uninterested in everything. Even though I'm off of all these meds now, that feeling unfortunately remains to this day.
In September of '08 I began college after 3 years of little to no real life schooling or social interaction and of course the anxiety was an issue but the total lack of focus and energy was just as much of a problem and is what eventually led me to drop out in January of '09. In my current state, I can't see going back and trying again at college or even going out and doing something like a daily 9 to 5 job. The still-prevalent anxiety is a factor in this, but the constant feeling of total fatigue, unfocusedness and apathy is just as much of an issue.

So now the reason why I'm posting here: like I said, I've been diagnosed with ADHD for 8 years. However, I've never been prescribed any ADHD medications, i.e. Adderall or Ritalin, because of their potential to make my anxiety issues much worse. My high blood pressure and heart rate (which I believe is a result of the anxiety) is another factor in doctors not wanting to give me any type of stimulant medication. The problem is that the ADHD is holding me back so much in life that continuing this way is not an option I'm willing to take. It's frustrating beyond belief knowing I have the capacity to do things but I lack the focus and energy to ever get started or follow through with any of them. I've been given virtually every other non-stimulant medication there is in attempts to treat this, but like I said, they've only made things worse. Most of them have just had the effect of turning me into a zombie, which is the exact opposite of what I am trying to achieve.
My main question here is this: how can I, given my issues with anxiety and hypertension, effectively take an ADHD medication? The problem isn't just convincing a doctor to give me a medication, either...I'm fairly sure I could do that if I just saw a new doctor and neglected to mention the anxiety or hypertension/palpitation issues, but I'm concerned for my own health as well as the potential of worsening anxiety, so I wouldn't want to take anything if I thought it would present a large danger to me. Yet on the other hand, continuing to go unmedicated and live out the rest of my life accomplishing nothing because of how bad the ADHD has gotten doesn't seem like a very good option either. So what can I do? Any help or advice on the matter would be much appreciated.

Last edited by Administrator; 09-28-2011 at 12:22 AM.

 
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Old 06-07-2010, 08:23 PM   #2
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Re: Anxiety and hypertension preventing taking medication for my ADHD; what can I do?

Are you aware that there are non-stimulant ADD medicines, such as Strattera? It's something to look into.

 
Old 06-09-2010, 02:48 AM   #3
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Re: Anxiety and hypertension preventing taking medication for my ADHD; what can I do?

Desipramine is a tricyclic antidepressant that helps ADHD, and shouldnt make your anxiety worse - might be worth asking about

You ould take a beta blocket to control your heart rate and BP - it might even help your anxiety some

Last edited by jonnstar; 06-09-2010 at 02:52 AM.

 
Old 08-30-2010, 04:41 PM   #4
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Re: Anxiety and hypertension preventing taking medication for my ADHD; what can I do?

I doubt that the diagnosis of ADHD is still valid, get a better work up which included psychological testing Is it so tough to hear and read what is presented, but you are very young and what you are talking about is a concern for your cognitive and thinking self. find a person you can trust-- sometimes a real challenge and then get the testing. bless you for your resiliency and perserverance.

 
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