So, I'm at an impasse. I've tried to deal with my symptoms of ADD(poor exec function, discrepant VIQ/PIQ), anxiety, mood for 18 years officially, and now at 33, I've tried so many lifestyle changes and therapy types and medications with no avail. Every week, there are new frustrations, and I can't keep to the strategies in therapy. Rather things seem amplified and innumerable. I can accomplish things sporadically, but there's not enough strategies to implement to overcome my exec. function issues. The older I get with not being able to control the quality of my work, the harder it is, as I am not underemployed and would like to start a family before I'm too old. I'm on Pristiq, memantine, Strattera (40 mg, poor CYP2D6 metabolizer), and atenolol to deal with the increased heart rate from the Strattera. I also have an SCL6A4 Short allele and CACNA1C mutation. I function, but very suboptimally.
My mood looks like mood reactivity in atypical depression. In some respects also similar to the way mood congruent delusions are described for psychotic depression. My beliefs in my incompetence have some validity, but are pretty strong. If there's an event that I believe should be my fault, I can convince myself of that, even if there are other lines of reason.
Overall, my threshold for handling many negative, stressful or risky things is low. It is more challenging for me to do complex tasks or have a busy schedule (I'll still be processing a conversation two hours after it happened, because I didn't fit the details together, I do it all at once, rather than stepwise). And so inherently, things can be more frustrating as I try to lead a fuller life.
Concurrently, it feels like I can't just focus on any one thing. There seem to be 1000 things to focus on. As is evident of this email. I can't just note one, and re-order and re-visit. I just act based on immediacy and recency.
Mood-wise:
I would like to stay away from antipsychotics. I know MAOIs and lamictal were mentioned. Would there be anything else? I can't find anyone comfortable with prescribing them or versed enough in my own issues.
I suppose I'm stuck with my gaps in ability to process/plan and organize information? I've tried a lot, but noting works.