Since the discussion has become very focused on many aspects of depression and possible treatment, I thought I'd add a little more about my mental health background.
Since I was in elementary school, my teachers have suggested that I may have ADHD. My parents, not wanting to medicate their child, were strongly opposed to me pursuing any line of treatment. In high school, the teacher who came to know me best was my Debate Coach. She spent years having a close-up perspective of all my study and preparation habits. During my senior year she was describing my debate ability to my mom after I had nearly missed my final debate. Her main point to my mom was that I fitted her archetype of "the absent minded professor".
I would say that most of high school was comparable to Junior/Senior year in Undergrad. I would never carry folders, I just stuffed notes into my backpack or in the front cover of my books. I would never keep a schedule and I would never keep any sort of external reminders. If a class assigned homework I would miss about 10-15% of assignments either because I had forgotten about the assignment or I had missed class when it was assigned, or simply because I procrastinated and then some last-minute technical difficulty (no access to a working printer, lost the book that had the problems I needed, slept in on the morning I was supposed to finish it, etc) ruined my chances of turning it in. Even when I was at my best (Freshman in Ugrad) I was still showing up late for some exams/midterms and lose out on precious testing time (not just 5 minutes, my worst cases were 45m-1hr into 3 hour exams).
I finally got sick of being such a mess and sought help in Ugrad. The counselor was sympathetic and was fairly certain I had ADHD, Inattentive type. Unfortunately her plan for the "next step" was for me to undergo battery testing for ADHD that would run $1000+. Given that I was completely broke, I just had to write off any chance of getting serious help my senior year.
As a 1L, when I finally got the financial aid and had some hope of following up on treatment I was split about it. I felt like I was just falling into all the stereotypes of law students medicating themselves to get ahead. However, I started miss readings/class and fall behind so I finally got to see a psychiatrist on my old (garbage) insurance through my network. It was almost impossible to find someone available in Manhattan so I pretty much took the first opening I could get. Unfortunately, long story short, the guy was ancient and his mind clearly what it wasn't used to be. He was living in another generation and his advice (beyond reading Driven to Distraction) was largely unhelpful, I had to stop seeing him when he would begin to repeat his advice (but not aware he was doing it, he thought it was a "new" suggestion each time) during every meeting. I tried Ritalin, and then Adderall (generic). The Ritalin had absolutely no noticeable effect. The Adderall essentially resulted in me hyperfocusing on whatever was in front of me when the medication kicked in. The problem was that I would become fascinated with even the most mundane things, and while having an extreme interest in a tort case was definitely an improvement over my prior condition, spending 2-3 hours reading/doing background research/drawing economic formulas for a single case wasn't ideal either. I stopped taking the medication when I found myself increasingly distracted while on the medication (i.e. spending hours reading about baking your own bread and looking up bread machines on Amazon.com) and growing sick of the side-effects. All in all the medication was a relatively brief stint that didn't do much to shape my studies 1L year.
I haven't really sought help about ADHD since I sunk into depression. When I started seeing a mental health counselor who holds open-door sessions at the law school last November, it was primarily to deal with increasingly depressing and suicidal thoughts. I'm currently on Wellbutrin for anti-depression, but its also used to treat ADHD and I'm hoping that I still might see some kind of breakthrough. I'm still weighing the possibility of going back on adderall, I think there are some things I could change to increase its effectiveness, and perhaps switching to XR or a brand could have benefits as well. Just to help color your perception of what I deal with, here's the DSM-IV list of inattentive-type ADHD symptoms:
[*]Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
[*]Often has trouble keeping attention on tasks or play activities.
Often does not seem to listen when spoken to directly. (This doesn't apply at all)
[*]Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
[*]Often has trouble organizing activities.
[*]Often avoids, dislikes, or does not want to do things that take a lot of mental effort for a long period of time (I cannot tell if this is caused by procrastination or whether my procrastination is caused by whatever chemistry causes this sort of problem).
[*]Often loses things needed for tasks and activities. (Can't tell if this is due to my disorganization or I lose things more than "average", either ways its not a strong symptom for me)
[*]Is often easily distracted.
[*]Often forgetful in daily activities.
One symptom that wasn't mentioned that I've seen elsewhere was time management/time awareness. I have a huge problem with perpetually being overconfident in my ability to do something in an allotted time, to the point of being irrational about it. This had led to me being consistently late to countless events/classes. When combined with the anxiety that's developed in law school, it exacerbated my attendance issues because I didn't want to embarrass myself by walking in 10 minutes late. I would almost always chose my departure times for "ideal" conditions, and would be late when the Subway/Bus/Travel Route took any extra time whatsoever, or if I would leave and forget something and be forced to come back for a phone/ID/card/etc. I think this may also play a role in my struggle with the time-intensive exams in law school. It's no coincidence that I have done extraordinarily well on take-home exams but have a solid B average on the time-intensive proctored exams. In 7/8 of the proctored exams I have taken, I would get to the last question with under 20% of the allotted time for that question remaining. This would always leave me with a rushed, rambling paragraph as the answer for the last question in almost every proctored exam that I've taken. Everytime I could start going over the time for Q1 I would just tell myself "Oh it's only 10 minutes over, I can make up the time later" or "Well it was worth the extra time to get a quality answer".
Anyway, I'm sure this will influence what many of you may be suggesting to me and the problems I face that may or may not be caused by ADHD have helped fuel the pessimism and feelings of hopelessness that have taken root during my depression.
Last edited by Throwaway2013
on Mon May 07, 2012 4:18 am, edited 1 time in total.