ADHD Case Study

As far back as middle school, Stefanie, now 32-years-old, could tell something was wrong with her ability to pay attention. “I knew I was smart, so I didn’t understand why I struggled so much to get my homework done,” she said. At one point in the 7th grade, one of Stefanie’s friends was diagnosed with ADHD, and it was like a lightbulb went off for Stefanie. She told her parents that she was really struggling, and maybe the ADHD medication that had helped Angie could help her, too.

“My dad just rolled his eyes and said, ‘You want to take medicine for being lazy, is that right?’ I never asked my parents for help with my focus again,” Stefanie recalled. She studied and worked as hard as she could to make it through school. Stefanie noticed she always needed to study for much longer than her friends. Even with all the extra hours she spent at the library, she graduated from college with a GPA she wasn’t proud of. Still, after graduation, she eventually landed a job at a decent company. A few years later she met her husband, and started a family with him.

It wasn't until shortly after the birth of their second child that Stefanie realized that all of the systems she had created to help her navigate the day-to-day and stay on track were not effective anymore. She began getting written warnings at work for missing deadlines. With the amount of effort, she spent trying to keep it together at her job, there was little energy left over once she got home. Laundry piles seemed to grow larger every day. Her older son felt neglected. Stefanie and her husband were having trouble connecting, and they rarely had sex. Stefanie was scared of losing her job and felt helpless about improving her home life.

As the pressure mounted, Stefanie felt she had to get some help. She filled out Upper Valley Behavioral Health’s online application. After her application was reviewed, her initial visit was scheduled for later in the same week. During her telehealth visit with her board-certified provider, Stefanie discussed her history and how her symptoms were impacting her life today.

In that initial visit, Stefanie’s Upper Valley Behavioral Health provider recommended a starting dose of a medication for ADHD. He sent an electronic prescription to Stefanie’s local pharmacy, and she was able to pick up her medication and start it that same day. Over the next few months, Stefanie continued to meet regularly with her provider, over secure video telehealth visits on her phone. Her ADHD medication dose was slowly adjusted until it got to the most helpful level for her symptoms.

Six months after her initial visit with Upper Valley Behavioral Health, Stefanie couldn’t believe how much her life had changed for the better. She now reports being more focused and calm at her job. Because she’s not so worn out from trying to keep herself on task at work, she has more energy and joy at home. Every day after work, she looks forward to playing with her two kids. She’s even rekindled the spark and intimacy she and her husband once experienced together.

For Stefanie, it was a challenge to seek assistance after being dismissed by parents when asking for help as a teenager. Now, she’s glad she took that step. “I had no idea that the right medication would make such a difference for me.”

Anxiety Case Study

“I guess I’m afraid of everything, basically,” is how Libby described herself at her intake appointment. The 34-year-old stay-at-home mom explained how she always found herself envisioning the worst-case scenarios in her life. “If my husband is five minutes late on his way home from work, I’m sure he’s gotten into a car accident and is dead. As I’m trying to figure out how I’ll pay the bills and take care of the kids alone, he walks through the door and sees that I’m a wreck.”

Libby’s constant worrying made it hard for her to focus on her day-to-day schedule, like when her daughter’s soccer game was. She relied on her online calendar to keep everything organized, but even so, she might forget to get a present for her son’s friend’s birthday party or misunderstand when her husband had an evening work event scheduled. Libby felt that her husband and kids were always disappointed with her, and that made her feel terrible.

Libby knew that her workarounds and coping mechanisms for dealing with her anxiety weren’t always helpful, either. Because of how tense being in big stores made her, Libby ordered everything online. But this led to unnecessary purchases at times that only made Libby stress about storing it all. Social situations were stressful, too. She always needed at least a glass of wine or two to get through any gathering, but over time, this had led to weight gain.

Her friends and husband sometimes teased her saying, “What do you have to worry about? You don’t even work!” Libby tried to laugh it off, but she felt ashamed of her inability to keep it together.

The low point came when Libby’s husband excitedly came home and told her he’d been offered a work promotion that came with a move to his company’s Los Angeles office. Libby became very upset, saying she would never be able to move to LA--what about earthquakes? After hours of fighting and tears, her husband realized that he would truly have to turn down this opportunity.

A few days after this episode, Libby found the online application for treatment at Upper Valley Behavioral Health. The week after completing her application, she was attending her virtual intake appointment with her provider. She told her provider it wasn't that she didn’t believe something was wrong with her--she knew there was. Libby had just never believed that help from medication would be worth the potential side effects.

However, Libby’s Upper Valley Behavioral Health provider worked diligently with Libby to meet her needs. He recommended a medication to Libby that wasn’t likely to cause weight gain or decrease her libidio--the two side effects she most wanted to avoid. Her provider also recommended an as-needed medication for breakthrough symptoms. After her provider electronically sent these prescriptions to her local pharmacy, Libby was able to pick up the new medications that evening.

After a few months on her new medication, Libby reported feeling much better. She could attend her husband’s work events or a birthday party without needing to reapply deodorant throughout the event and without relying on alcohol as a crutch. She managed her kids’ activities much more easily. The best part is how Libby and her husband are feeling connected and back in sync. “I told my husband to go ahead and start looking for another promotion!” says Libby with a smile. “I can handle a move now.”

Depression Case Study

Jim, a 36-year-old with a wife and family and a job he loves, would never have considered himself to be depressed. “I had a normal, happy childhood,” he said. He was a high school baseball player. While he wasn’t a strong enough athlete to play for his college team, Jim continued to play club sports throughout college. He enjoyed his studies and excelled at school.

After college, Jim began his career at a chemical engineering firm, and he began working his way toward management. He met and married his wonderful wife. They had three children, and Jim is proud and happy to watch them grow. However, ever since his kids were born, Jim had been slowly gaining weight. As his feelings of pressure to be a good provider intensified, he was eating for comfort more and more. Although looser clothes were hiding his bulge, the former athlete was disappointed by his love handles.

He also began having trouble sleeping, and he woke up several times a night. This led to serious fatigue during the day. Although his work performance didn’t outwardly suffer, Jim began to feel exhausted and drained during the workday. He noticed a pattern of needing to drink two to three energy drinks daily to “feel normal” and make it through work.

At home, Jim found himself being short and irritable toward his wife. He snapped at her frequently then felt guilty afterwards. Jim tried to make it up to his wife with flowers and surprise jewelry.

“I don’t think our friends had any idea I was struggling with this sleeplessness, anger, and stress,” Jim stated. “I looked like I had it made; I posted happy-looking pictures of our Vegas anniversary trip on Facebook.”

Inside their home, though, both Jim and his wife felt something had to change. At his wife’s urging, Jim visited the Upper Valley Behavioral Health website. He completed the application for treatment. Within a few days, Jim was attending a secure telehealth visit with his board-certified provider. As Jim and his provider explored his symptoms together, a picture emerged of how Jim could be treated.

When his Upper Valley Behavioral Health provider suggested to Jim that he start on an antidepressant, Jim felt confused. He was edgy and tired, not sad. But his provider let him know that trouble sleeping, stress, and snapping at his family could be signs of depression, too. Jim was willing to give the medication a shot, and his provider sent an electronic prescription to Jim’s local pharmacy that day.

Within a few weeks of starting the medication, both Jim and his wife noticed an improvement in his sleep and his attitude. However, Jim still noticed low energy and a short fuse at times. By communicating with Jim regularly over telehealth sessions, Jim’s provider was able to assess the problem. The provider added a second medication to Jim’s regimen, and within weeks, Jim really began to respond. He felt much more energetic, without the need for energy drinks. He wasn’t feeling irritable toward his wife anymore.

Jim expressed that without the convenience of virtual visits, he might not have been able to stick with the appointments needed to get him back to his healthy, happy self. “Stress and pressure still exist, but I seem to handle it so much better,” Jim said recently. Jim and his wife are thrilled to have their loving marriage back, and Jim is even starting to get back into shape.