ADD: Coping with Compulsive Thoughts and Sleep Issues

Mental health issues

In January of this year, I was diagnosed with Attention Deficit Disorder (ADD) and am currently taking Ritalin.
The issue is that I often experience a feeling of "compulsion to do something." I frequently check at home to ensure that the faucet is turned off, the refrigerator is closed properly, and the drawers are shut.
Recently, this feeling has become more intense, and the "compulsion to do something" keeps reminding me.
It is most pronounced at night before I go to sleep, when I find myself thinking about various things, making it difficult to fall asleep.
I often feel exhausted and suddenly fall asleep, as if I have lost power.
Additionally, I have been waking up without any recollection of what happened before I fell asleep, as if I remember being in my room, but when I wake up, I find myself at the table or in an empty room next door where no one lives.

I, 20~29 year old female. Ask Date: 2018/03/07

Dr. Xiao Minghong reply Psychiatry

Hello Mr.
I,
Ritalin can be very effective for attention deficit and hyperactivity disorder (ADHD).
Due to its ability to enhance attention, using it in the evening may affect your sleep quality.
Additionally, it seems you are experiencing some repetitive thoughts, which you have had since childhood; this could indicate a worsening of your symptoms.
In rare cases, some individuals may develop similar symptoms after taking Ritalin.
Lastly, you mentioned difficulty recalling events that occurred before bedtime.
If you are also taking sedative-hypnotic medications, this could contribute to that issue.
I recommend discussing these three points with your primary physician to reassess your condition and consider any necessary adjustments to your medication.
Wishing you all the best!
Sincerely,
Dr.
Hsiao Ming-Hong

Reply Date: 2018/03/07

More Info

Understanding Attention Deficit Disorder (ADD) and its impact on sleep can be quite complex, especially when compounded by compulsive thoughts and behaviors. It seems you are experiencing a range of symptoms that are not uncommon among individuals diagnosed with ADD, including obsessive thoughts and sleep disturbances.
ADD, or Attention Deficit Disorder, is characterized by symptoms such as inattention, impulsivity, and sometimes hyperactivity. However, it can also manifest in ways that affect daily functioning, including sleep. The compulsive thoughts you describe—such as the need to check if the faucet is turned off or the refrigerator is closed—are indicative of obsessive-compulsive tendencies, which can coexist with ADD. This can create a cycle of anxiety that exacerbates sleep issues.

Coping Strategies for Compulsive Thoughts and Sleep Issues
1. Cognitive Behavioral Therapy (CBT): Engaging in CBT can be particularly beneficial. This form of therapy helps individuals identify and challenge negative thought patterns, replacing them with more constructive ones. A therapist can work with you to develop coping strategies for managing compulsive thoughts and anxiety, which may help improve your sleep quality.

2. Mindfulness and Relaxation Techniques: Practicing mindfulness meditation or relaxation exercises before bed can help calm your mind. Techniques such as deep breathing, progressive muscle relaxation, or guided imagery can reduce anxiety and prepare your body for sleep. Apps or online resources can guide you through these practices.

3. Sleep Hygiene: Establishing a consistent sleep routine is crucial. Aim to go to bed and wake up at the same time every day, even on weekends. Create a sleep-conducive environment: keep your bedroom dark, quiet, and cool. Avoid screens (phones, computers, TV) at least an hour before bedtime, as the blue light emitted can interfere with melatonin production and disrupt your sleep cycle.

4. Limit Stimulants: Be mindful of your intake of caffeine and nicotine, especially in the afternoon and evening. These substances can increase anxiety and disrupt sleep. Additionally, alcohol, while it may initially make you feel sleepy, can lead to fragmented sleep and increased wakefulness during the night.

5. Medication Management: Since you are currently taking a medication (likely a stimulant like Adderall), it’s essential to discuss any side effects or concerns with your prescribing physician. Sometimes, adjusting the dosage or timing of medication can alleviate sleep issues. Your doctor may also consider prescribing a non-stimulant medication to help with anxiety or sleep.

6. Journaling: Keeping a sleep journal can help you identify patterns and triggers related to your sleep disturbances. Write down your thoughts before bed to clear your mind. This can also help you track your sleep patterns, which can be useful information for your healthcare provider.

7. Physical Activity: Regular physical activity can help reduce anxiety and improve sleep quality. Aim for at least 30 minutes of moderate exercise most days, but try to avoid vigorous exercise close to bedtime.

8. Consult a Sleep Specialist: If your sleep issues persist, consider consulting a sleep specialist. They can conduct a sleep study to rule out conditions like sleep apnea, which can significantly impact sleep quality and overall health.

Understanding Your Experiences
The feelings of being unable to remember what happened before sleep and waking up in different locations can be concerning. This may indicate a deeper issue related to sleep quality or even dissociation, which can occur in individuals with ADD or anxiety disorders. It’s crucial to discuss these experiences with a mental health professional who can provide a comprehensive evaluation and tailored treatment plan.

In summary, managing ADD alongside sleep issues and compulsive thoughts requires a multifaceted approach. By incorporating therapeutic techniques, establishing healthy sleep habits, and seeking professional guidance, you can work towards improving both your mental health and sleep quality. Remember, you are not alone in this journey, and there are effective strategies and support available to help you cope with these challenges.

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