'Mental or Reading Blocks' & Studying
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Q:  'Mental or Reading Blocks' & Studying

After I was diagnosed with bipolar disorder in 1984 during my last semester of high school, I noticed a drastic change in my level of concentration and extreme difficulties in reading.  Fortunately, I finished undergraduate school, in a ten year period.  Now, I am desperately trying to muster up the strength for graduate school; however, I have started and stopped three times after experiencing "mental or reading blocks" when it came time for studying.  Are there any tests or medications that I can take to determine where to go from here?
Thank you,

Dear Mr. J' -- 
This is tricky.  There's some sort of relationship between bipolar disorder and "ADHD", and it almost sounds as though you got the latter when you got the former.  However, most of my patients who have symptoms like yours also have other mood symptoms.  So I usually focus on the mood symptoms, and try to get those controlled first (this is the general consensus among mood experts, regarding the order in which to treat BP and ADHD symptoms).  Then if attention problems persist, I might consider adding a stimulant, and several of my patients have done extremely well with such a regimen -- including going back to school and starting new jobs.  So far it does not seem as though the stimulant, which I am generally very reluctant to add, has been a destabilizing agent in these select patients -- but there are child/adolescent specialists who do worry about that potential.  

So, whether you got yourself formal testing or a specialist diagnosis of ADHD or not, I think this is the kind of consideration you'd end up coming down to anyway:  should you add a stimulant and how much risk to your bipolar disorder might that present?  However, I'm not an ADHD specialist and there might be other tools to consider that I'm not aware of. 

Finally, I should also note that I've seen such attention problems resolve when the mood symptoms were controlled, at least as often as not -- though we don't know from your question whether  mood symptoms are present for you at all; perhaps not.  I hope you find something that will allow you to take that next step. 

Dr. Phelps

Published March, 2003


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