Need ADD Study Tips

[Medicated]

After over a year of tumultuous PA school culminating in an involuntary psych hospitalization (for depression) and subsequent medical leave of absence, I've recently been told that I'm ADD/ADHD... and that the ADD likely caused or heavily contributed to the stresses in my life which preceded my fateful nervous breakdown. Wow.

I shouldn't be surprised by the diagnosis. My classmates mocked me for my inattentiveness in lectures. I was incapable of studying - no matter what I tried, as soon as I opened the powerpoints or the book, my brain was elsewhere. I would concentrate, wrestle, and beg it to stick around, but no such luck. (Imagine a TV set to auto-surf... it lingers a few seconds on each channel and it just keeps switching...) I'd be lucky to get 5 solid minutes of studying in. After a while this scene became so frustrating that I almost stopped trying, although I would begin every new unit by saying "THIS time, I'll get my act together!" And yet, I always seemed to be looking at the materials for the first time the night before (or morning of) the exam.

It's a mystery to me, but somehow I made it through the first year.

I was on my 3rd rotation (of 10) when I flamed out in late September - at that point, basically all aspects of my life were completely disorganized and out of control, not just my schooling. It was bad. Really bad.

Anyway, I've been home from the hospital for four weeks now. It's been rocky, but I'm doing okay. I just started ADD meds last week, so we're still tinkering with those. However, I know that meds alone won't cure me; I need a new approach to school and life too.

As I mentioned, I'm on a leave of absence now (until the end of the year), but because I feel like I didn't learn much in my first year (go figure), I'd like to use some of my spare time studying and catching up. However, I feel like my study habits are so dysfunctional (non-existent) that I don't know where to start. I'm hoping that there are some others on these boards who have also dealt with similar ADD-type challenges in relation to PA school who can help me get on my feet.

As a right-brained, visual thinker, how should I go about trying to study? What methods work best for those of you who have ADD? In regards to clinical rotations, are there other adjustments that you recommend I look into, which could make my life a little easier (or at least less chaotic)? Are there any books or websites or resources that you would recommend? Sage words of wisdom?

Thanks for your help!

(Sigh... What a ride.)

[Febrifuge]

Wow, my story is similar, but I was lucky and had the attention of faculty (though I didn't want it at the time) and I made aggressive use of my school's resources to avoid a flame-out like yours. I met once with a time-management person; she had a lot to say about systems with several different colors of highlighter, and scheduling stuff, but it didn't make much of an impression on me.

I had already heard, and believed, that the trick is not to schedule the work - you schedule the breaks, and the digressions. Even if it's just "I'm going to read this half of the page, make sure I really get it, and then go make a sandwich," that's half a page you don't have to read again. And I talked through stuff a lot - everybody I know has questions, and I try to make sure I know my stuff well enough to explain it to somebody who's not in medicine. There were times I had to talk to the cat, but processing verbally helped me way more than staring at a page, so I talked.

I guess if any one thing really helped me (I mean, aside from starting on meds) it was remembering why I was there, and what I was working toward. This is my second career; I was able to get by, coping and adapting, as the "eccentric, smart one" in my niche of corporate America. But medicine, to me, is not just complex and difficult, it's cool. It's what I used to read about for fun, when it wasn't the focus of my life. Remembering that made it easier. Find the coolest part of what you're studying. It almost certainly won't be on the test, but it can help break up the tedium.

[pkubin]

I just got into PA school - I'm coming to it from psychotherapy. I'm no expert in ADD/ADHD, but I've worked with more than a few in situations like yours. There are a few things you might try. You will, of course, need to experiment with what works for you.

-experiment with gauging how focused you feel at different times since taking your meds and try to study when you are at your best. Usually folks with ADD are at their most attentive in the hour or two after taking their meds.

-Ritualize your study any way you can. For people who have trouble focusing and planning, HABIT and routine are often key.

-Google "mind mapping." There's a lot about it on the internet (avoid mind mapping software - it can become a time waster). Mind mapping is drawing a map of ideas and how they relate. It could help you focus on the big picture, since that's what gets lost when people are easily distracted.

-Experiment with doing other things while studying. I know this sounds crazy, but if the theory holds that restlessness comes from slower areas of your brain
creating motion and activity to stimulate themselves, sometimes that activity is crucial. Put your laptop on the counter, turn on some music, have a squeezy thing to play with, etc. and move back and forth between each. Why sit? Most with ADD/ADHD (even with meds) find it frustrating and counterproductive to try to get quiet, hunker down and focus on one thing at a time. Some of us are tigers - built to zero in on prey, and some of us are birds - good at keeping a lookout for threats and needs.

I wish you luck. You can do this!

[dfwpa]

A lot of local therapists have started offereing biofeedback training for kids w/ ADD. They use a computer to help train the kids how to focus...and they claim it helps. The OP might want to google that/look into it.

[Medicated]

Thanks everyone.

I've been trying various doses and forms of adderall, and while it helps me focus and be productive, I don't like how it makes me feel. I do have a hard time believing that adding distractions will help me... I can't even listen to music with lyrics while I study because I invariably sing along (or at least focus on the lyrics) instead of reading! I'd never heard of the biofeedback until recently, but I don't know where I would go, whether it would be covered by my student insurance, and if I could even fit it into my clinical year schedule. I'll keep it in mind though.

I've just started meeting with a counselor who I'm hoping can help me figure some of these things out. Sometimes I doubt the ADD diagnosis and think my problem is just a lack of motivation/willpower due to depression. Hmmm... does my distractibility lead to the depression, or vice versa? Tough to say.

Thanks again for the replies. I'll keep trying different things.

[NeuroQueen]

Thanks for sharing your story, Medicated... What you went through wasnt easy nor probably tell us the details. I have not experienced what you went through personally, but I do understand that everyone has a breaking point and that you were lucky that a therapist was able to help you pin down your problem. I hope that you find a method that works for you so you can continue your road to becoming a PA....

[dfwpa]

Medicated: In my experience w/ ADD tx and meds, Adderall can be effective, but it can cause a lot of SEs. I've found that the Ritalin family of meds tend to be better tolerated by many...this would include Ritalin LA, Concerta, Daytrana, and Focalin/Focalin XR. I've found in folks experiencing typical stimulant SEs, such as insomnia, dry mouth, constipation, sweating, tremor and palpitations, Focalin XR seems to be tolerated best.

OTOH, sometimes the Ritalin (methylphenidate) family isn't strong enough, in which case I'll go w/ Adderall or Vyvanse

Just my $0.02

[Medicated]

dfwpa - I tried straight-up ritalin for about 10 days (at doses up to about 20mg BID and TID) and I think I may as well have been taking sugar pills. The adderall helps me focus and be productive, but I do get a lot of the side effects from it, even at 10mg (but worse at 20... duh. ). So yeah, it works, but when I'm on it, I feel just... gross... like a serious caffeine OD. It's fairly unpleasant. Why anyone would want to abuse the stuff is beyond me. I don't know much about Vyvanse... aside from that it's really expensive. On the whole, it seems like the ritalin was mostly useless, and the adderall is perhaps too strong. There's got to be a happy medium... but I guess this is a conversation I ought to be having with the psychiatrist, and not you. haha Thanks for the input though. This is all totally new to me, so I appreciate all the information I can get.

[Medicated]

Thanks for sharing your story, Medicated... What you went through wasnt easy nor probably tell us the details. I have not experienced what you went through personally, but I do understand that everyone has a breaking point and that you were lucky that a therapist was able to help you pin down your problem. I hope that you find a method that works for you so you can continue your road to becoming a PA....

Thanks.

[Nickster]

There are a lot of fairly effective ADD meds on the market today, and its definitely worth trialing several of them. In my case, Adderall worked pretty good like you described, but I felt too "medicated." Ritalin was a waste of time, Focalin didnt work so well, etc.

There is also Dexedrine and Vyvanase that have been successful to some people that I have not tried. Anyways, give a few of them a shot and be patient, its simply a matter of trial and error.
You might also consider taking something like Wellbeutrin or Lexapro in addition to an ADD med to combat some of the side effects related to anxiety or libido, etc. It may take a while to get the right medication and dose, but it could very well be out there.

On a different note, what I have done is said no to drugs. My ADD/ADHD is very similar to what you describe but I dont want to be on meds the rest of my life simply because I cant focus. While fighting a chemical imbalance in your brain is tough, it can be done in some instances.

For me, Ive found very specific times I can study, places, and methods that have helped me be somewhat successful studying during my undergrad. Im sure by now your well aware of all sorts of things you can try, but it will be up to you to figure out how to be able to focus on the things you need to.
In the case where you believe you "simply can't" focus, that's exactly why...

All this being said, is there any chance you have the ability to hyperfocus on things you "want" to focus on?
If so, there may be some other avenues you have yet to explore...

[slprncess]

Medicated..
I am also a VERY visual learner! I was introduced to this method by an instructor of mine. I print out a picture of whatever system we are on and make multiple copies. I use one pic for each dz that is related to that system. I put key points on it to jar my memory. I also use a voice recorder for my commute (1hr each way) per day. These are things that I have felt have helped me. I find myself many times staring at the book and wondering what I just read. All it took for me is to change my way of studying and I think it has helped me. Just keep trying different things and see what works for you.
I wish you the best!

[Medicated]

There are a lot of fairly effective ADD meds on the market today, and its definitely worth trialing several of them. In my case, Adderall worked pretty good like you described, but I felt too "medicated." Ritalin was a waste of time, Focalin didnt work so well, etc.

There is also Dexedrine and Vyvanase that have been successful to some people that I have not tried. Anyways, give a few of them a shot and be patient, its simply a matter of trial and error.
You might also consider taking something like Wellbeutrin or Lexapro in addition to an ADD med to combat some of the side effects related to anxiety or libido, etc. It may take a while to get the right medication and dose, but it could very well be out there.

On a different note, what I have done is said no to drugs. My ADD/ADHD is very similar to what you describe but I dont want to be on meds the rest of my life simply because I cant focus. While fighting a chemical imbalance in your brain is tough, it can be done in some instances.

For me, Ive found very specific times I can study, places, and methods that have helped me be somewhat successful studying during my undergrad. Im sure by now your well aware of all sorts of things you can try, but it will be up to you to figure out how to be able to focus on the things you need to.
In the case where you believe you "simply can't" focus, that's exactly why...

All this being said, is there any chance you have the ability to hyperfocus on things you "want" to focus on?
If so, there may be some other avenues you have yet to explore...

I have also hoped for a solution aside from drugs. I've been on some psych med or another for about 15 years now (hence the SN), so I'm never happy to add a new one, especially if it makes me feel like crap. That being said, I have taken wellbutrin in the recent past, and I'm strongly thinking about asking to go back on it, either instead of, or in addition to the adderall. An antidepressant may not be a bad idea for me at this point...

Most often, I end up hyperfocusing on things that I don't particularly want to focus on. I'm the queen of rumination. However, there have been times when I have really gotten into some project or another for several hours or even a few days. That doesn't happen very often though. I generally still get bored even with things I like, but the potential for incredible attention span is there, given the right conditions (whatever those are).

Historically, I have attributed my inattention to a lack of desire, motivation, and willpower... depression, or just sheer laziness. I actually think the adderall helps motivate me as much as it helps me focus. It's a kick in the pants which makes me want to work toward a goal, and gives me a little energy and focus to do so... but because of that, I kinda think the core issue here is depression and the ADD-type issues are exacerbated by it... and that the adderall is just acting like the stimulant that it is. Not that that's always a bad thing - I can use the help right now - but I don't think it's the final answer.

I'll give it a few more days and make some real attempts at studying in the meantime before I go back to the doc to discuss other options. I still have work to do when it comes to figuring out what study environments and techniques work best for me.

Medicated..
I am also a VERY visual learner! I was introduced to this method by an instructor of mine. I print out a picture of whatever system we are on and make multiple copies. I use one pic for each dz that is related to that system. I put key points on it to jar my memory. I also use a voice recorder for my commute (1hr each way) per day. These are things that I have felt have helped me. I find myself many times staring at the book and wondering what I just read. All it took for me is to change my way of studying and I think it has helped me. Just keep trying different things and see what works for you.
I wish you the best!

Thanks. I am a visual learner inasmuch as when I am trying to recall a piece of information I have studied, I can see the textbook page in my head - remembering that it was in the right-hand column, about halfway down, under some picture that was mostly pink/brown. Same for powerpoints... I can picture the slide, but I can't always "see" the words on it... just how they were laid out. Interestingly, I have never found flowcharts and tables to be particularly helpful - if anything, it's like sensory overload and they overwhelm me. My eyes glaze over... too many boxes and intersecting lines!! AAAAA!!! Panic! But some people swear by them... different strokes for different folks, I guess.

I downloaded some medical podcasts, but I have trouble paying enough attention to those while I'm driving or on the train to make them worthwhile. I still wish my program recorded lectures for us... I thin the reason they don't is twofold - technological impairment, and a fear that it will encourage us to skip lectures.

I might try your systems/key points technique, but I fear that I would spend more time setting it all up than actually reviewing and learning. I'm prone to overdo it on my attempted study techniques. Might be worth a shot though. Thanks for the suggestion!


... in other news, I just realized that I took more of the adderall than I really meant to this morning (20mg vs 10mg) and now I'm all tense and jittery. Ugh.

[Jambi]

Anyone have experience with Strattera?

I don't do well on stimulants at all (I look and feel like death) so I've resorted to exercise and behavior modification, which has had varying degrees of sucess. The big thing for me was, and still is, learning to be aware of the reactions/compulsions/etc, and once I knew they were happening and what they were, I've been able to exercise a measure of control over them. Still, with varying degrees of sucess.

Lately, I've been eyeing strattera as a milder alternative to the hardcore stimulants.

[2livecrews]

I used several different ADD meds throughout undergrad including strattera, Adderall, concerta, daytrana, and ritalin. I stopped about my senior year and haven't used them since. I didn't see much effectiveness from strattera. It takes several weeks to kick in and is a non stimulant. I would think it is used for milder ADD. Concerta and Daytrana are basically the same thing, except the latter is a patch. They are both time released and work well. Adderall is the strongest and most effective but has the worst side effects. The XRs made me sick, but I liked taking a 5 or 10mg pill for a nice 5-6 hour study session. I have never taken Vyvanse but the word is that is a cleaner version of adderall with less side effects.

[COTA for now]

Read a book called The Out of Sync Child. It's about non-pharm therapy for kids with special needs, including ADD/ADHD. The concepts apply to people of all ages.

This article, while not about ADD/ADHD kids, describes the basis for this therapy, and its application across the gamut of people. http://www.tsbvi.edu/Outreach/seehea...mannerism.html

We use alot of sensory strategies in the special needs school, both for multi-sensory education, and to provide sensory diets and "fidgets" to help keep kids focused.

Also, try using a timer, and setting it for say 5 minutes at a time.