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Clinical experience suggests that, in psychotic patients, administration of amphetamine may exacerbate symptoms of behavior disturbance and thought disorder. Adderall side effects can aggravate or cause psychosis in patients with existing mental conditions. Patients with previous mental conditions should be carefully monitored for signs of Adderall psychosis. This Adderall risk can be significant given that a large percentage of people suffering from ADHD also suffer from co-morbid psychological disorders.


I. ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)
Source: www.wiki.medpedia.com

Adderall is indicated for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) A diagnosis of Attention Deficit Hyperactivity Disorder (ADHD; DSM-IV®) implies the presence of hyperactive-impulsive or inattentive symptoms that caused impairment and were present BEFORE age 7 years.

The symptoms MUST cause CLINICALLY SIGNIFICANT impairment, e.g., in social, academic, or occupational functioning, and be present in two or more settings, e.g., school (or work) and at home. The symptoms must not be better accounted for by another mental disorder.

For the Inattentive Type, AT LEAST six of the following symptoms MUST have persisted for at least 6 months: lack of attention to details/careless mistakes; lack of sustained attention; poor listener; failure to follow through on tasks; poor organization; avoids tasks requiring sustained mental effort; loses things; easily distracted; forgetful.

For the Hyperactive-Impulsive Type, AT LEAST six of the following symptoms MUST have persisted for at least 6 months: fidgeting/squirming; leaving seat; inappropriate running/climbing; difficulty with quiet activities; "on the go;" excessive talking; blurting answers; can't wait turn; intrusive. The Combined Type requires both inattentive and hyperactive-impulsive criteria to be met.


II. FALSE CLAIMS OF "ADHD" IN COLLEGE STUDENTS

Attention Deficit/Hyperactivity Disorder (ADHD) affects 2-3% of college students. These students may also have other disorders, like reading or math difficulties, or dyslexia (writing problems).
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However, while juggling many social and academic obligations, similar problems occur with students who don't have ADHD. Some students - who think they have ADHD - only need help in managing their time and developing efficient study methods.
...
Psychologist Michael Gordon (director of the ADHD program at the State University of New York Health Sciences Center at Syracuse) ... is worried that those who misuse the diagnosis of ADHD will undermine the credibility of those who have ADHD. Faculty members are likely to become skeptical of that diagnosis. However, most people who seek to be categorized as ADHD actually do have the disorder.

The confusion is fueled by the lack of documentation about ADHD from those who diagnose the condition. Health professionals believe that colleges need to be furnished with more personal data. It is similar to the information required for workman's compensation or to get a handicapped-parking sticker. The students need to be examined by licensed professionals - psychiatrists, neurologists, clinical or educational psychologists. Gordon and others have recommended guidelines to be used by these professionals.

- Rule out other problems or disorders. Other disorders may have symptoms similar to ADHD. There are no specific tests for ADHD. However, there are measures of depression, anxiety, stress, substance abuse, or various neurological or mental disorders. If a student - who lacks academic ability - becomes overwhelmed and inattentive in class, this can be mislabeled as ADHD.

- Find a past history of the disorder. Legitimate cases of ADHD tend to start at an earlier age, rather than erupting in college. In the United States, about 5-7% of children and up to 5% of teenagers are diagnosed as having ADHD. Typically there will be a "paper trail" of reports of unruly and inattentive behavior. Erratic performance on standardized tests is another indicator. Some who misuse this diagnosis whiz through undergraduate school. However, they ask to have ADHD privileges when they get into graduate school.

- Check for significant, debilitating ADHD symptoms. In the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), 14 symptoms are listed for ADHD. Students should exhibit at least five of these symptoms. The symptoms include such things as forgetfulness, failure to complete or do well on class assignments, fidgeting and high levels of distractibility. These symptoms must be severe enough to interfere with their school, work or social functioning.

Source: "Homework Help: Social Studies: Psychology: The ADHD Student Scam?"
by David A. Gershaw, Ph.D.


III. DRUG ABUSE AND DEPENDENCE
Source: www.wiki.medpedia.com

Adderall is a Schedule II controlled substance.

Amphetamines have been extensively abused. Tolerance, extreme psychological dependence, and severe social disability have occurred. There are reports of patients who have increased the dosage to levels many times higher than recommended. Abrupt cessation following prolonged high dosage administration results in extreme fatigue and mental depression; changes are also noted on the sleep EEG. Manifestations of chronic intoxication with amphetamines include severe dermatoses, marked insomnia, irritability, hyperactivity, and personality changes. The most severe manifestation of chronic intoxication is psychosis, often clinically indistinguishable from schizophrenia.

Adderall carries a black box warning—the STRONGEST warning issued by the FDA short of a drug recall—informing consumers about the SERIOUS RISK of Adderall abuse. This Adderall warning states that taking amphetamines for long periods may lead to Adderall ADDICTION. The warning details the significant risks posed when Adderall is taken for non-therapeutic use or is distributed to others. The Adderall black box warning also states that misuse of Adderall can cause SUDDEN DEATH and serious cardiovascular events.


IV. PROLONGED USE:

Prolonged high doses of amphetamines followed by an abrupt cessation can result in extreme fatigue and mental depression. Chronic abuse of amphetamines can result in the manifestation of amphetamine psychosis. "Adderall XR prescribing information". Shire US. March 2009.


V. PERSONALITY DISORDERS

Patients suffering from personality disorders have many things in common:

1. Most of them are insistent (except those suffering from the Schizoid or the Avoidant Personality Disorders). They demand treatment on a preferential and privileged basis. They complain about numerous symptoms. They never obey the physician or his treatment recommendations and instructions.

2. They regard themselves as unique, display a streak of grandiosity and a diminished capacity for empathy (the ability to appreciate and respect the needs and wishes of other people). They regard the physician as inferior to them, alienate him using umpteen techniques and bore him with their never-ending self-preoccupation.

3. They are manipulative and exploitative because they trust no one and usually cannot love or share. They are socially maladaptive and emotionally unstable.

4. Most personality disorders start out as problems in personal development which peak during adolescence. They are enduring qualities of the individual. Personality disorders are stable and all-pervasive – not episodic. They affect most of areas of life: the patient's career, his interpersonal relationships, his social functioning.

5. Patients with personality disorders are rarely happy. They are depressed and suffer from auxiliary mood and anxiety disorders. But their defenses are so strong that they are aware only of their recurrent dysphorias – and not of the underlying etiology (problems and reasons that cause their mood swings and anxiety). Patients with personality disorders are, in other words, consciously ego-syntonic, except in the immediate aftermath of a life crisis.

6. The patient with a personality disorder is vulnerable to and prone to suffer from a host of other psychiatric problems. It is as though his psychological immunological system is disabled by the personality disorder and he falls prey to other variants of mental illness. So much energy is consumed by the disorder and by its corollaries (example: by obsessions-compulsions), that the patient is rendered defenseless.

7 Patients with personality disorders have alloplastic defenses (external loci of control). In other words: they tend to blame the world for their mishaps and failures. In stressful situations, they try to preempt a (real or imaginary) threat, change the rules of the game, introduce new variables, or otherwise influence the outside world to fulfil their needs. This is as opposed to autoplastic defenses (internal loci of control) typical of neurotics (who change their internal psychological processes in stressful situations).

8. The character problems, behavioral and cognitive deficits and emotional deficiencies and instability encountered by the patient with personality disorders are, mostly, ego-syntonic. This means that the patient does not, on the whole, find his personality traits or behavior objectionable, unacceptable, disagreeable, or alien to his self. Neurotics, in contrast, are ego-dystonic: they do not like who they are and how they behave.

9. The personality-disordered are not psychotic. They have no hallucinations, delusions or thought disorders (except those who suffer from the Borderline Personality Disorder and who experience brief psychotic "microepisodes", mostly during treatment). They are also fully oriented, with clear senses (sensorium), good memory and general fund of knowledge.

Each personality disorder has its own form of Narcissistic Supply:

HPD (Histrionic PD) – Derive their supply from their heightened sexuality, seductiveness, flirtatiousness, from serial romantic and sexual encounters, from physical exercises, and from the shape and state of their body;

NPD (Narcissistic PD) – Derive their supply from garnering attention, both positive (adulation, admiration) and negative (being feared, notoriety);

BPD (Borderline PD) – Derive their supply from the presence of others (they suffer from separation anxiety and are terrified of being abandoned);

AsPD (Antisocial PD) – Derive their supply from accumulating money, power, control, and having (sometimes sadistic) "fun".

Borderlines, for instance, can be described as narcissists with an overwhelming fear of abandonment. They are careful not to abuse people. They do care deeply about not hurting others – but for a selfish motivation (they want to avoid rejection).

Borderlines depend on other people for emotional sustenance. A drug addict is unlikely to pick up a fight with his pusher. But Borderlines also have deficient impulse control, as do Antisocials. Hence their emotional lability, erratic behavior, and the abuse they do heap on their nearest and dearest.


VI. THE HATED-HATING PERSONALITY DISORDERED:

One needs only to read scholarly texts to learn how despised, derided, hated and avoided patients with personality disorders are even by mental health practitioners. Many people don't even realize that they have a personality disorder. Their social ostracism makes them feel victimized, wronged, discriminated against and hopeless. They don't understand why they are so detested, shunned and abandoned.

They cast themselves in the ROLE OF VICTIMS and attribute mental disorders to others ("pathologizing"). They employ the primitive defence mechanisms of splitting and projection augmented by the more sophisticated mechanism of projective identification.

In other words:

They "split off" from their personality the bad feelings of hating and being hated – because they cannot cope with negative emotions. They project these unto others ("He hates me, I don't hate anyone", "I am a good soul, but he is a psychopath", "HE IS STALKING ME, I JUST WANT TO STAY AWAY FROM HIM", "He is a con-artist, I am the innocent victim").

Then they force others to behave in a way that justifies their expectations and their view of the world (projective identification followed by counter projective identification).

The personality disordered are full of negative emotions, with aggression and its transmutations, hatred and pathological envy. They are constantly seething with rage, jealousy, and other corroding sentiments. Unable to release these emotions (personality disorders are defence mechanisms against "forbidden" feelings) – they split them, project them and force others to behave in a way which legitimizes and rationalizes this overwhelming negativity. "No wonder I hate everyone – look what people repeatedly did to me." The personality disordered are doomed to incur self-inflicted injuries. They generate the very hate that legitimizes their hatred, which fosters their social ex-communication.


VII. HISTRIONIC PERSONALITY DISORDER

Diagnostic criteria:

A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

(1) is uncomfortable in situations in which he or she is not the center of attention

(2) interaction with others is often characterized by inappropriate sexually seductive or provocative behavior

(3) displays rapidly shifting and shallow expression of emotions

(4) consistently uses physical appearance to draw attention to self

(5) has a style of speech that is excessively impressionistic and lacking in detail

(6) shows self-dramatization, theatricality, and exaggerated expression of emotion

(7) is suggestible, i.e., easily influenced by others or circumstances

(8) considers relationships to be more intimate than they actually are

Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, fourth Edition. Copyright 1994 American Psychiatric Association


VIII. NARCISSISTIC PERSONALITY DISORDER

Diagnostic criteria:

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

(1) has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)

(2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

(3) believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)

(4) requires excessive admiration

(5) has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations

(6) is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends

(7) lacks empathy: is unwilling to recognize or identify with the feelings and needs of others

(8) is often envious of others or believes that others are envious of him or her

(9) shows arrogant, haughty behaviors or attitudes

Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, fourth Edition. Copyright 1994 American Psychiatric Association

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katy59
Posted on 3/5/2010 at 9:43AM
all of the above



foldman
Posted on 3/5/2010 at 11:28AM
Many of us ... ... , or sought help through medicine, religion and psychiatry. None of these methods was sufficient for us. Our disease always resurfaced or continued to progress until in desperation, we sought help from each other in Narcotics Anonymous.



foldman
Posted on 3/5/2010 at 11:42AM
Don't mistake what I said. There are mental disorders. People that honestly have them need professional help. But to offer someone a recipe to walk into an office with (to get drugs) is just wrong.



gordonr
Posted on 3/5/2010 at 5:34PM
Extremely dangerous stuff, Doctors have no idea what these drugs really do, too many fatal contraindications, only treat symptoms, do not get to the root causes, DANGEROUS. I am an addict, want to esacape, do not want to look at the skeletons in my closet, take the easier softer way, could have gone this route, thank God I did not. I know too many cases where psychotic pills, anti-psychotic drugs, anti-depressants have done more harm than good. I know God will heal and restore me, the fellowship-I am not alone.


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ValerieT ValerieT
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Mar 16, 2010