I have ADD with significant EF issues along with anxiety and mood issues. Given the course of my issues (wasn't diagnosed until college, struggled my way through things with massive life imbalance), missing social cues and not being able to consistently maintain relationships with friends, I have an ingrained fear of failure and rejection sensitivity. I have tried therapy, and work with a coach, but I can't keep to anything because of my EF issues things fall off the table week to week and my frustration feelings are intense. I spend most of my time trying to plan my work out because I can't do that efficiently. My life is so discontinuous and imbalanced.
I've seen this now mentioned as part of ADD and atypical depression. The only treatments for it that I've seen mentioned, nootropic/supplement wise or medication wise, are MAOI and intuniv/clonidine.
What complicates any med decision is that I have some cardiac issues that pop up with medications. Currently on strattera and pristiq and intuniv and have baseline tachycardia. Several years ago, I had developed exercise induced tachycardia after being on wellbutrin. I can only go up to 2 mg intuniv because I get pretty hypotensive. As long as I'm on intuniv, I can't take advantage of a lot of things like Li orotate and fish oil.
Are there other medications that might work on the rejection sensitivity issues? What neurotransmitter is believed to be responsible for this? It seems intuniv and MAOI have very different mechanisms. And if it were a norepi thing, the SNRI's would play a role as well. My concern is that I will need to have something for EF in addition to whatever I use to manage my mood, and I worry that an MAOI isn't fantastic to combine things with.
Would appreciate any thoughts/suggestions.