Friday, July 29, 2011

Day Three - Sins of the Father

As excited, happy, and hopeful that I am now that I'm on the road to a more centered, productive, and healthy me, it's a little bittersweet. I have a lot of regret for what could have been had I only known earlier in my life that I had this problem. I regret having been so hard on myself, and for many of the choices that I made as a result of my shaky self-esteem.  I regret that I didn't get nearly as much out of my Cadillac education that I could have if only I had been able to keep my ass in a chair long enough to study.  I regret spending so much time regretting things.

ADHD affects the way your brain works and hence how you function in the most mundane ways. The symptoms of ADHD impact whether or not you can ever be a "morning person;" how much you talk; your level of motivation to complete little tasks and big projects; your ability to absorb, retain, and process information; whether or not you can ever make it to work on time.  In other words, it effectively shapes who you are in the world, or. . .who you seem to be.

What I now realize, about myself at least, is that you don't have any frame of reference to evaluate how your brain functions. If you happen to be someone who suffers from the effects of ADHD, and have been that way for as long as you can remember from childhood, you have no reason to know that there is something amiss that is beyond your control. You may be very well aware of your "shortcomings." But you attribute them to boredom, laziness, impatience, etc. - in other words, situational emotional states or your "personality." 

Very likely, you've been told throughout your life by people who love you (and people who don't) that you just need try harder, pay attention better, worry less, study more, stop arguing, quit being so lazy or self-centered, buy a day planner, settle down, get a clue. . . .  You've been told to do a lot of things that most people take for granted are within their control.  But you're not most people.  And you haven't figured that out yet.  You just know that you try as hard as you can to do all these things, and you can't.  To the extent that you can, it takes Herculean effort and drains you emotionally and even physically.  Without meaning to, you disappoint, hurt, irritate, and anger people, especially yourself.  And you might just decide that it's because you're a "bad" person.

Admittedly, I can only speak for myself - based on my own experience - but I'm of the opinion that if you don't know you have ADD/ADHD, there is no way to know you have ADD/ADHD. Unless, that is, you are a reasonably self-reflective person and happen upon revealing information that offers that elusive frame of reference for self-evaluation.

For me, that information came in the form of my beloved child.  I'm the proud mom of two amazing boys.  My kids are nearly six years apart in age, so I had a lot of time to get to know and bond with my eldest as an "only child."  "Joshua" takes after both of his parents in various ways, as all kids do.  But if one of my kids can be considered my "mini-me," it's Josh.  Josh has always been an engaging, smart, funny, and social child.  Ever since he was an infant, I could relate to him and empathize with him.  I "got" him and all his quirks.  Like any proud parent, I delighted in watching him, over his early years, develop positive traits that reminded me of myself. 

But, of course, we all have faults and shortcomings, and though I saw my boy growing up into who I would consider a wonderful little person, I also saw other things.  Things that pained me.  Josh was impatient, pushy.  He had no respect for boundaries.  He was easily bored and couldn't stay on task.  He was overly emotionally sensitive and quick to anger and frustration.  Yes, it pained me immensely.  Not because I judged him.  I love him with all my heart and will always think he's the bees knees, no matter what.  No, it hurt me to see these traits develop in him because they mirrored me.  And I suffered because of these traits.  I don't want my children to suffer.  I desperately wanted Josh to be better than me.

Shortly after Josh started school, he began suffering from anxiety and some other issues that his dad I and weren't really equipped to deal with effectively.  Josh's pediatrician recommended that I take him to see a psychologist.  Long story short, Josh was diagnosed with a rather prounounced case of ADHD. 

I was skeptical at first.  I had believed, like many people do I think, that ADHD - while a legitimate diagnosis for some - was overused as an excuse to sedate perfectly normal children who were too much of a handful for their inept parents.  I didn't get it.  But I was willing to listen.  Something inside me was telling me that I needed to keep an open mind for Josh's sake.

Over the next several months, I spent a lot of time researching ADHD, and grew satisfied that this was an appropriate diagnosis for my son.  I spent a lot of time thinking about my little boy - who he was, what he was like.  He reminded me so much of my dad.  My wonderful, funny, brilliant, cute, interesting, engaging dad.  God, I miss my dad

My dad died unexpectedly when Josh was a baby, probably the single most painful thing in my life to date.  My dad so looked forward to grandchildren, and he and Josh would have been two peas in a pod. 

As I thought about my dad in those days, I remembered things about him, lots of frustrating things, actually.  He was constantly talking to himself.  From childhood through adulthood, I would have to yell at him to get his attention when I tried to tell him something because he was conversing silently with someone in his own head.  I'd know this because his lips were moving. 

Dad never came to school functions.  He couldn't sit through them.  He couldn't sit through anything that wasn't completely interesting to him.  Although he was a generous and compassionate man, he could be horribly self-centered and oblivious to the needs of others.

My dad had an amazing mind.  My dad - an immigrant - was a factory worker with only an 8th-grade education.  Yet, he was one of the most intellectually gifted people I have ever known, though I never saw him read a book.  He could have easily matched wits with any of  my hoity-toity college professors any day of the week.  But he didn't know that about himself.

As I thought about my dad and my son, I remembered how fragile my dad's self-esteem was.  I remember him saying to me one day when I was an undergrad, "Daughter, work hard.  Study hard.  Don't be lazy like your old dad.  You pay attention to your teachers.  I could never pay attention to my teachers.  I was too impatient.  You know, your old man didn't want to be a factory worker.  But I never had the motivation to do anything else.  But you can be anything. . ."

At some point in the course of my research, I learned that ADHD is hereditary.  I recalled a conversation that I had with my mom once when I was a young adult.  My mom told me how she had watched a news show where they talked about this thing called, "ADD."  My mom, who was not particularly educated or worldly, had never heard of it.  But what she learned on this program struck a chord with her.  "I think your dad has that ADD thing."  At that time in my life, I had certainly heard about ADD/ADHD, but I didn't know anything about it.  "Naw," I said to her dismissively, "Dad doesn't have that.  That's something that kids get.  Dad's just impatient and bored."

That conversation came back to haunt me, more than a half-a-decade after my dad's death, as I reflected on my son, the similiarities between grandfather and grandson, and my growing knowledge about this insidious disorder.  A light bulb went off.  You were absolutely right, Mom.  Dad had ADHD. 

Though Dad had never been diagnosed, and never would be, I now knew the truth about him.  Dad, you were wonderful and brilliant and gifted.  I'm so sorry you never got to be the person you wanted to be.  I forgive you for not listening to me and for being annoying.  I understand that you did the best you could.  It wasn't your fault. . . .

Eventually, as I continued to think about these two guys, my "mini-me" and my "maxi-me," the light bulb finally went off.  (ADHD sometimes makes it hard to see what's right in front of your face.)  My son's struggles, my dad's struggles. . . were my struggles.  I was the middle-link in this genetic chain. 

After all these years, I now know that I'm not an inherently defective, bad person.  There is hope for me.

Wednesday, July 27, 2011

Day Two - First Day with the New Feet

When I was little, I thought it was a hilarious joke when a person would trip or stumble, and someone would say, "What's wrong - first day with the new feet?" That would just make me laugh and laugh. Truth be told, it still makes me chuckle, and I love it when one of my kids trips (without injury, of course) and I get to say it to them. (Dr. K., you might want to modify your notes to reflect that, while good, my sense of humor is woefully dorky.)

Well, yesterday - my first full Adderall XR day - felt a bit like my first day with the new brain. I continued to feel relaxed and happy, but a little awkward and "wobbly." Walking around with my inhibitory receptors now awake was strange, and all day long I kept noticing weird things. Things that I'm sure normal people with normal brains find perfectly normal. But for me, they were strange.

Like when I got to my desk and found that I had a voicemail. Instead of staring at my phone and agonizing over whether to take the message; and then taking the message and debating over when to call the person back; and then deciding to wait until some unspecified more-convenient time in the future (the technical term for which is "later") to call the person back; and then losing the note where I jotted down the message; and then not ever returning the call because I either forgot to or never wanted to in the first place; and then getting another call--this time an angry one--following up on the first one that I never returned. . . instead of all that, I simply took note of the red message-indicator light on my phone. And without even giving it a moment's thought, I picked up the phone, took my message, called the person back. Done.

People with normal brains won't get why this is a big deal. You're supposed to return calls. It's a given. But the sleepy-receptor people know exactly what I'm talking about. All of us sleepy heads have agonized in the middle of the night over those phone calls--the phone calls you wouldn't return for no other reason than because you just didn't feel like it, regardless of what consequence might ensue.

It's not just about the phone calls. It's about the daily business of living. If you're an adult who suffers from ADD/ADHD, your life has been turned into unmanagable chaos at one time or another just because you couldn't bring yourself to pay that bill (even though you had the money in the bank and the check was already written out), or fill out that application form in time, or open an important certified letter marked "URGENT."

To us sleepy-receptor people, seeing a task before us and just doing it is, in fact, a very huge deal. The hugest. And being able to check something off of a to-do list can feel like winning a gold medal.

This is some good shit, man. . .

Tuesday, July 26, 2011

Day One

"So what took you so long to seek treatment?" asked my new psychiatrist. "I didn't know I had a medical problem. I thought I had character flaws," I responded dryly. Dr. K. nodded in that way that doctors do when a patient presents with something that piques their interest, like a suspicious mole. . .or a case of kuru. "Oh,you have a good sense of humor, I see."

Apparently not good enough to actually make her laugh. Instead of laughing at my joke (which wasn't so much a joke as it was a deeply painful admission), Dr. K. took her pen and noted it in my file. ". . .good sense of humor. . ." I was glad for that. I may never achieve my fantasy of becoming a revered author of wildly comical novels; but at least now my good sense of humor has been documented by a licensed professional. Take that, Guy-Who-Doesn't-Think-I'm-Nearly-As-Funny-As-I-Think-I-Am! Someone who is an expert in brains thinks I'm funny!Once we established the existence of my sense of humor, Dr. K. read through my file. "You definitely have ADHD. Did you take the TOVA [Test of Variables of Attention]?  Oh, here it is. . .what was your score? Hmmm. . .yes. . .quite pronounced." I just sat there nodding as she recited from my file. I considered interrupting her with an "I'm sorry, did you say something?" But I refrained because I figured that a psychiatrist who treats ADHD people regularly has probably heard that one already, at least a few thousand times.

As Dr. K. continued to review my file, I strained my eyes to read the notes, from across her desk, and upside down. I was curious to know whether Dr. R., the psychologist who evaluated and diagnosed me, wrote down the words "poster girl." I figured he probably hadn't because that would have been unprofessional. But what others regard as unprofessional, I often find hilarious and evidence of a good sense of humor. (Dr. R., please consider your good sense of humor documented.)At my first appointment with Dr. R.--during which I filled out questionnaries and regaled him with family history replete with people who talked to themselves, and tales of extreme scatterbrainedness--Dr. R., looked up at me from his notes at one point and said, "You might just be the poster girl for ADHD." (Oh, Dr. R., go on. I bet you say that to all the inattentive ladies.)

Huzzah! Huzzah! Yes, please make me the poster girl! First of all, I've been feeling a little underappreciated these days - I could use a little recognition.

More importantly, a diagnosis of ADHD would answer so many questions. It would provide an explanation for the struggles I have experienced for 40-plus years - struggles that destroyed my self esteem and made my hopes and dreams of creative accomplishment seem like impossible fantasies. Struggles that made me feel like an imposter and a liar to anyone who actually was duped into believing I was competent. Struggles that threatened to end my marriage that I thought were all my fault for being a fat, lazy, defective, impatient, self-centered, stupid, unmotivated, and all-around gross person.

A diagnosis of ADHD would give me hope. It would mean that maybe I could take medicine. Maybe the medicine would help me, and the daily business of living wouldn't be so damned hard anymore. Maybe I could become the person I always wished I could be. . .

". . .The medicine won't change your brain," Dr. K. explained. "You'll still have your same brain. But it will wake up your brain, stimulate the inhibitory receptors and help alleviate your symptoms." I was excited. Yes, Yes, lets wake those inhibitory babies up; rise and shine, inhibitory receptors, who- or whatever the hell you are!

"So, Doctor, if I start taking the pills, how long will it be before I notice a difference. . .if they work, that is." "Oh, the medication works," Dr. K. assured me. "We know that it works. We might need to tweak your dosage, but you should notice a difference right away."

Alrighty then. . .what are you waiting for Doc?! Get your note pad out and start writing. I've got places to go, people to see, gee, I hope my hubby isn't trying to reach me because I forgot my phone at home, I'm due to get back to work, my boss is going to be pissed, I'm hungry, my back itches, did I put that load of wash in the dryer? where the fuck is my debit card, I saw a duck once. . .I'm sorry, did you say something?

God, I can't wait to get my hands on those pills. Please, Lord, let them work. My brain and body are exhausted. I'm desperate. I'm broken. I've tried as hard as I can. I can't do this anymore. Please let them work. . .

I left my appointment determined to stop at the very first pharmacy I saw. I barely drove a block before I came to Shopko. Yay! The pharmacist told me that it would take twenty minutes to fill my prescription. Twenty minutes! What, are you having it delivered in by stagecoach?! ADHD makes it very hard to wait for things.

After what seemed like an eternity, the nice lady handed me my pills, Adderall XR, 20mg. During that grueling twenty-minute wait, I grabbed a soda from the cooler so that I would have a beverage in hand with which to wash down my maiden pill at the first opportunity. (Did I mention the waiting problem?) The pharmacist looked at me a little cross-eyed as I cracked open the auburn bottle and swallowed a capsule right there as she was still handing me my product papers and before I had even paid. Sorry, Lady, I got big plans. I don't have time for your delightful spiel today.

An hour or so later, back at the office, I prepared for a check-in meeting with one of the members of my staff.

Meetings have always been a bit of a challenge for me. Talking at meetings I could do. For hours. Nonstop. Just ask any of the members of my long-suffering gracious staff. As it turns out, I exhibit "verbal hyperactivity" as part of my condition. And here I thought I was charming and engaging. Oh, well. (I actually still think I am charming and engaging, but I understand that a little bit of that can go a long way.)

Listening, on the other hand has always been extremely difficult. I would mean to listen. I wanted to listen. I understand the theoretical importance of listening. I would try very hard. But I usually couldn't do it for very long. Too many stimuli all around me begging. . .screaming for my attention. There was a clock to watch, fingernails to pick, birds flying past the window, conversations from last night that I needed to rehash mentally and analyze. . .right then. But I would nod, and say "hmm" a lot. Occasionally write down a couple of words (or "notes") that were completely illegible and wouldn't mean anything to me later. I looked like I was listening and participating. But, in truth, I wasn't even there.

So here I was, preparing to go into a meeting. I noticed that I was starting to feel a tiny bit strange. I can't describe exactly what it was--kind of like the sensation you get after you've taken a decongestant. A little wonky. It's too soon, I thought. It must be my imagination.

Now in my meeting, sitting across from my assistant, I started to realize that, in fact, something was happening. The physical effects were obvious. My head started to tingle. I began to feel a strange chill run up and down my arms--a sensation that I've never experienced before. My tongue felt big. As I talked to my assistant, I found myself experiencing some difficulty talking. It's hard to describe it--my mouth would be trying to form words, but the words were not coming to mind at the same time. Speech and language were suddenly out of sync. All of a sudden, I had become the embodiment of a 1960's Japanese martial arts movie in which my mouth would physically shape words, but the words came fractions of a second after. I've been told--and however unkind the statement, it might be true--that my mouth works faster than my brain.

I was a little frightened. Was I having an allergic reaction? heart attack? A stroke?? I took a deep breath and in just a few moments, that sudden, initial fear of the unfamiliar subsided as I started to notice other things. . .wonderful things. I noticed that I was calmly seated in my chair. I wasn't fidgeting or looking at the clock every two seconds as if I had someplace else I needed to be. I was comfortable, for a change. No physical urge to wiggle around or leave the room. I just sat back in my chair and relaxed while I listened to my assistant express her concerns and ideas. Wait, did I just say, "I listened"?

Joy bubbled up in side me as I realized that I was listening to my colleague. She was talking, and I was hearing her. I understood what she was saying. I took notes that were actually legible and coherent. I felt no urge to interrupt her. I wasn't busy planning my next sentence as she uttered hers. I wasn't planning what I was going to make for dinner. I was there. With her. Listening.

Now, to be realistic, this wasn't the first time I've ever listened before. I hold multiple academic degrees from reputable institutions of higher learning. I'm a respected professional. I know to put the square pegs in the square holes and the round pegs in the round holes. By objective standards, I'm a reasonably accomplished person who couldn't have gone through life never having listened.

What made this moment remarkable was that it just happened. I didn't have to try. I didn't have to fight any urges or compulsions. My body didn't tense up. I didn't hold my breath as I often do. My brain didn't hurt at the end of it. Sitting in the meeting and listening to another human being talk felt as easy and natural as breathing. And this, I can say with all honesty, was the first time I can ever recall that being the case.