Depression/ADHD Motivation Problems

I don't know if this is the right place to post this or if there even is a place to post this. I just need to talk about stuff sometimes and I can't feel better until I tell someone and they hear me. Probably hardly anybody will read this and probably nobody will reply, but I might as well try.

I have anhedonia, the lack of ability to feel a sense of pleasure or reward from an activity, and this combined with my inability to stay focused means I can hardly do anything at all. (Plus chronic fatigue, sort of-- my doctor recognizes that I am chronically fatigued, but won't give me the label Chronic Fatigue Syndrome because he believes the Major Depressive Disorder label explains it well enough.) It's a bid deal if I manage to get up the motivation to shower on a given day. I've been in therapy for 4.5 years, and some things have started to get better; my mood swings haven't been as drastic and my emotions haven't been quite as extreme-- except the emotions of anger and emptiness. I still can't work, but I've been trying to volunteer once a week, and do some yardwork for my sister twice a week. The problem is I can't sustain these new activities because I still have no motivation or energy.

In the past, I've managed to do the bare minimum to stay functional because of being prescribed adderall. It was originally prescribed for my ADHD but it's also the only thing that helps my anhedonia and gives me any sense of motivation. But now my tolerance for adderall is so high I don't even notice it. This is partly due to natural tolerance building but also due to the weight I recently gained ( thanks to the mood stabilizer Trileptal), which causes some medicines to effect you less strongly. I see my psychiatrist on Friday and I plan to tell him I can't feel adderall anymore and I need to try something similar or else go way up on the dose. But there's two problems. First, he might not want me on more stimulant since I'm not working right now. I'm worried he doesn't understand that I literally (yes, literally) cannot get out of bed without adderall. Secondly, even if he agrees to switch to vyvanse or ritalin or increase my dose, I will have to wait 3 weeks to pick it up. Because I just picked up my adderall a week ago and the pharmacy won't let you pick up any more for 30 days.

So, long story short, I don't know how to function for the next three weeks. My sister has entrusted me with her yardwork, but how can I get it done when it takes an hour of mentally preparing and using DBT skills just to fold a load of clothes? I want to help the animals by volunteering at the local no-kill animal shelter, but how can I? I want to find the will and motivation to hang out with my friend this week and prove I'm getting better, but without adderall working in my system, I just don't think it's possible. What am I supposed to tell everybody? "Sorry I have to take a break from life for three weeks." ?! So if anybody has any feedback or encouragement, please help.

I feel for you. I empathize with you. I was where you are a few years ago.

I've struggled with recurring depression/anxiety for 15+ years. I took antidepressants for the first few years, but once my condition improved, I tried to manage it without medication ... I've tried almost every supplement I could find that's said to be good for my mood, but none gave me permanent relief from my condition ...

Several years ago, my depression started to worsen, I felt hopeless and my life was worthless, often couldn't get out of bed until the afternoon, started avoiding social events as much as possible and became a hermit. I wasn't suicidal, but I sometimes felt like I didn't care if I died in some kind of an accident (so that it won't be too much of a burden to my family compared to taking my own life).

I realized I was at the end of my rope and had to seek some serious help, so I finally saw a doctor and got some antidepressants prescribed. After going through Lexapro, Prozac, Effexor, Celexa (they either didn't work or had bad side effects), I decided to try Bupropion. Have you ever tried it? It's often prescribed for ADHD too. If you haven't, you may want to ask your doctor's opinion about it. (I hear it's a common tactic to combine Bupropion + SSRI or SNRI.)

Bupropion is a slow-working med. It takes several weeks to show its full effect. But there are some who instantly (within a week) feel better. I didn't. But I stuck with it simply because I didn't want to change the med again and I'm glad I did. It wasn't a smooth ride though ... Bupropion is a norepinephrine-dopamine reuptake inhibitor and it works as a stimulant but also can increase anxiety/restlessness, exacerbate OCD, which happened to me. But it was resolved by reducing the dosage and adding an SSRI.

I hope you find relief from your condition soon. But if you have to wait for three weeks, please just hang in there. Don't feel bad/guilty for not being able to be productive, it's not your fault. I read somewhere that a psychiatrist saying, "If you broke your leg, do you try to get better by forcing yourself to walk? When you have depression, don't force/stress yourself. You need to rest if you want to get better. Resting is the best course of action when you have an illness, whether physical or mental."

You will be in my prayers.

You have two replies. I used to believe I had ADD. I don't know now. I have major motivation issues that I talk to my therapist about. The way I handle it is to break things down into majorly small tasks. Like if you're in bed for a while, say to yourself, I'll lay in bed about another hour or hour and a half. You're already setting goals. Small and to others who are not you they may seem ridiculous or unrealistic, but you work with yourself. Then turn water on to shower after getting clothes ready and set on the bed for after you shower. For me it can be tiredness or fatigue, depression, or anxiety. Or all of these combined. I wish I had days where I could just stay home and do my own thing. Clean, watch tv, just whatever, but I have kids and we need groceries or take them to the dentist or to a football game. I can sometimes become very busy.

Anyway these are my thoughts.

Irene Iesu,
I also take Wellbutrin XL 300mg or Bupropion as it is also called. It works very well for me and the depression along with the other drugs combined.

Thank you both for replying.

Irene Iesu, unfortunately I have tried Bupropion multiple times over the last few years, and it either makes my anxiety worse, or does nothing at all when we lower the dose. Thanks for the recommendation though. I started Zoloft 5 weeks ago and it hasn't had any bad effects, so I'm hoping we can increase the dose and get me more motivated. Thank you for your words about resting and not blaming myself... I know what you're saying is true, but it's hard to accept it on an emotional level. I feel like I *should* be able to do more. I often hate myself for not getting things done. For the sake of being positive, though, I walked and/or jogged for thirty-five minutes today, which is more than I've done in a long time! I didn't make it to the animal shelter this morning though :/

Quietgirl2538, I agree it helps to break down tasks. Sometimes I forget to use that skill, but when I remember, it does help. Not that it solves everything. Today I really wanted to work on this story I'm writing, but even thinking of it paragraph-by-paragraph, I just can't focus. I've actually been tested and officially diagnosed with severe ADHD, so I know it's real for me. It sucks to have it alongside Depression. Anyway thanks for your thoughts.

I don't suppose either of you knows any tips to help improve focus?

kavajava wrote:Thank you both for replying.
Irene Iesu, unfortunately I have tried Bupropion multiple times over the last few years, and it either makes my anxiety worse, or does nothing at all when we lower the dose. Thanks for the recommendation though. I started Zoloft 5 weeks ago and it hasn't had any bad effects, so I'm hoping we can increase the dose and get me more motivated. Thank you for your words about resting and not blaming myself... I know what you're saying is true, but it's hard to accept it on an emotional level. I feel like I *should* be able to do more. I often hate myself for not getting things done. For the sake of being positive, though, I walked and/or jogged for thirty-five minutes today, which is more than I've done in a long time! I didn't make it to the animal shelter this morning though :/

I don't suppose either of you knows any tips to help improve focus?

Yeah, I kinda suspected that you might have. Have you tried Immediate-Release tablets? Both XL & SR tabs gave me insomnia, and my anxiety & OCD were exacerbated, but I experienced less (almost none) side effects (anxiety/irritability) after switching to IR tabs. And combing with an SSRI made a world of difference.

But now that we've discovered Zoloft has a positive effect on the dopamine level, this may be it for you. Your doctor should agree with you about increasing the dosage, if 50mg (this is only an initial dose) is not working. Hope it works out for you!

I completely understand how you blame yourself for not being able to do more ... you know what, I would tell others not to do that, but I do it myself ...(I'm guilty of "do as I say, not as I do" ) Sometimes it feels like everything is my fault. I'm also struggling to forgive and love myself. A friend of mine who also suffered depression once said to me, "Even if you spend the rest of your life sitting in your bedroom, or even if you become a mayor of our city, that doesn't change anything for me. I will love you just the same. I hope you can do that for yourself." ... so, I'm trying.

Tips to help improve focus? That's exactly what I want to know! One thing I try to do when I'm depressed and have no motivation for anything, I'll tell myself "Let's just do one thing, and one thing only today. What do you think you can do? ... take a shower, clean the kitchen counter, or water plants in the backyard? After you do either of those, you can come back to bed and rest ..." This often works by taking away the feeling of being overwhelmed by the so many things I should be taking care of. And more often than not, I'll be able to do more than one thing by focusing on "one at a time" ... I think this is very similar to what quietgirl said about setting small, achievable goals.

If you can walk/jog for 35 min., you are actually way ahead of me! I'm staring at my elliptical machine in the living room every day for the last six months, thinking I will hop on today ... !

quietgirl2538 wrote:I also take Wellbutrin XL 300mg or Bupropion as it is also called. It works very well for me and the depression along with the other drugs combined.

Yes, Wellbutrin is the brand-name. The active ingredient of the medicine is bupropion. My insurance doesn't cover the brand-name sadly so I'm taking the generic version.

For me it's the best med I've ever taken (tho the first couple of months weren't pleasant). Not only does it keep me wakeful throughout the day so I don't have to take a nap anymore, it took away my desire for drinking/munching and I lost 15 lbs.

What worked for me during those periods was splitting tasks into VERY small parts. I am sometimes too depressed and anxious to go do groceries. But I am not too depressed to move my left leg. Then the right leg. Then stand up. Then walk two steps. I divide it into really, really small tasks. If I get too tired at some point, it's okay to take a short rest, even if I actually am at the supermarket. (Nobody cares, and if they do, it's not my problem.) Then another two steps.

I don't know if this works for you, but it does for me. Good luck and big hugs if wanted!