Saturday, February 14, 2015

Holidays

I don't mean Valentine's day, although today is Valentine's day, which reminds me that I haven't done anything about it being Valentine's day, and do you capitalize "day"? I don't know. I haven't played the brewery instance in World of Warcraft in a while and that was really a fun one and what does that have to do with holidays? I hear you asking. Because no meds on weekends, that's why.

So this morning, wake up remembering that the big thing today is that two very dear friends whom we haven't seen in a while are going to be dropping by to visit and go out to lunch on their way home. This is about three hours ago. Ask B what we need to get done before they get here. B suggests that the kitchen needs work. I ask when he's planning on getting up, after some back and forth we arrive at about 9-9:30. Fair enough.

I head downstairs, let the dogs out, and play Plants vs Zombies for half an hour because when I opened my iPad it pinged at me that there was an alert in Plants vs Zombies. OK, put that down, turn on the stereo and start a playlist on the iPad, which is why I opened it in the first place.

Hold on, I have to go play Plants vs Zombies for a bit. BBQ.

OK, so I start the music and pick up my knitting because Becky is having a baby and I'm knitting a sweater and some socks and I need to get those done. Except I've been stitching fish into the sweater pattern and I don't really like the way they're turning out, so I'm going to go online and search for knitting fish pattern, and some of these are really cute, especially this one that's on socks - I need to post that on Facebook.

Don't go into the light, Carol Ann! But I head over to Facebook anyway and luckily there isn't anything too enticing there and I'm out and looking again for fish tessellations. I find one and start knitting, but somewhere the count is off and even though I keep trying to figure out how it is that this 12 stitch iteration is not actually fitting across my 87-stitch sweater 7 times, it doesn't.

So now I'm reading the article and I see that it mentions a knitting stitch pattern software goodness and I find something that says it's a copy of it but my anti-virus is telling me that I'm an idiot and that without it watching out for me 24-7, I'd basically be posting my bank account number in the clear on a billboard. Fair enough.

But then I find an article that compares several similar programs, and one of them should be clean, right? And I do, in fact, find one that is still available and may pass muster with my anti-virus, but I'll never know because it costs $185 and no way am I paying $185 for something that I could develop myself in only about 500 hours, by which time I could have knit a solid dozen baby sweaters. Nothing to do for it but to download Visual Studio Express and start coding. I've been wanting to brush up on C# anyway, this would be the perfect...

Now - right now as I'm typing this - B walks in and asks if our friends have been in touch. I don't know, maybe. My phone's in my purse, I didn't hear it, but could be. B says that friends called his phone, so would I check mine, but I'm busy sitting here, still in my pajamas, blogging about how I have trouble with setting priorities and following through. I'd love to finish this, but I have to go argue with my husband about why I have to do everything around here.

We're at Adderall-minus-45hours and counting.

Tuesday, December 2, 2014

Little White Pill

When I read ADHD sites, I see a lot of concern from parents about whether or not it's right to "drug" their kids. I think there's a perception that, since ADHD medications calm children down, it must be similar to giving a kid a dose of valium - the new Mother's Little Helper, only this time we apply it directly to the source of the problem.

This isn't valium.

I can only offer my experience with this medication and with this condition, but, if you are a parent and you are wondering about whether or not medication is ever right (I can't speak for always right, but I can say something about ever right), I do want to offer that experience and that perception. I'd like to try to give you an insight into what ADHD is like - what I suspect it's only possible to understand it's like when you have lived with it untreated and then had it treated.

These drugs aren't even remotely like valium.

Being on them isn't a dulling down. It isn't doping. It isn't drugging oneself into quietude.

Having untreated ADHD is like having your body embedded with a thousand fishhooks, with lines pulling you in every direction at once.

It's being unable, physically unable, desperately, despairingly, hatefully unable to stop watching a television. No matter how much you want to stop watching the television. No matter how hard you are trying to stop watching the television. No matter what price you are paying for watching the television. No matter what abuse you are pouring on yourself for continuing to watch the goddamn television. And then you get the drugs and you don't have to beg someone else anymore to please turn off the television and set you free.

Having ADHD is having the feeling that desserts were amputated from your mouth. You can go for weeks being acutely and persistently aware of the absence of a turtle brownie sundae from your tongue. You work on increasing your self-discipline. You try to deal with it as an emotional problem (maybe the sundae reminds you of something you want to experience again, like a childhood pet! a day at an amusement park! a beloved grandparent! your first date! a simpler time!) but the reality is that the food isn't about love and it isn't about security and it isn't about sex. That food is about carbohydrates and their ability to trigger the rush of dopamine that your brain is starved for (even if your body isn't) and all the self-discipline and therapy and weight watchers in the world aren't going to get you that dopamine, and the longer you put off getting it, the more and more trouble you're going to have functioning without it. You can get the dopamine pumping as needed by exercising yourself to a "runner's high" every two to three hours, but your body isn't going to take that kind of treatment indefinitely, you can get it by eating the sundae, which is an entirely different kind of way to mess up your body, or you can take the drug.

Having a kid with ADHD is exhausting. Having ADHD is even more exhausting. Until the diagnosis, until the drugs, I thought that the barrage of impulses and craving for stimulation that I experience was normal. If life on these drugs is what life is like for non-ADHD people - and the neurologists certainly seem to indicate that that is the case - then I'm at a loss for why the normals haven't solved all the world's problems by now, because life on these meds is life on easy mode. I used to berate myself for having poor self-discipline and poor impulse control, but that's hardly a fair assessment when the impulses and the cravings just never stop. With ADHD, you're catching yourself and pulling your attention back on track and knocking the distraction or the stimulation out of your hand not once an hour or even once every five minutes - you're chasing yourself down and rapping your own knuckles two or three times a second, every second of every day. The truth is, I'm amazingly self-disciplined and I deny myself about 99.9% of my impulses, but 0.1% of a staggeringly large number is a pretty substantial number in its own right. From the outside, it can look like I'm out of control; on the inside, I'm Nurse Ratchet.

This is not valium. This is a break, a step outside of a torrent of impulses and demands for attention, a sudden relief from the merciless, punishing pressure that, until you get the drugs, you didn't know life doesn't have to be like.

We are all captives of our own experience. Just as it is impossible for someone who does not have ADHD to truly understand the experience of having it and what they struggle with, it is impossible for someone whose ADHD has gone untreated to understand that, while their failures of restraint are visible, their almost infinite successes, unseen and uncounted, may dwarf those of the giants around them. I have never before understood the experience of people who found it natural to behave themselves. I have marveled at people who achieve success by "just doing the work." I have stood in awe of people who simply pay their bills on time every month, who rake their leaves as soon as they fall, who mail birthday presents on time and who don't feel a sense of overpowering need when confronted by a bowl of tortilla chips. I could not compare experiences, only results, and I could not understand how others managed to perform what are to me herculean feats as a matter of course. I was constantly berating myself for failing to live up to the examples set by my friends and colleagues, who made it all look so easy, because I could not understand that for them, it almost certainly is as easy as they make it look. To me, not having experienced the regulation that their brains naturally produce, it seemed like I was just a careless, irresponsible, thoughtless slob. Until the drugs allowed me to experience what life is like with a brain that is well regulated, I could neither produce visible achievements at the same level as my peers nor even give myself credit for my invisible success.

This is not valium. This is not a way to pep up or check out. It does not stupefy. It does not make you mellow (although being set free from the anxiety that comes with having to constantly police one's attention is a very relaxing thing). It doesn't turn you into a zombie or a drone. It only sets you free.

Friday, November 28, 2014

Drug of Choice

Usually I do 5mg of Ritalin at 11:00, when the munchies hit. It takes the edge off the compulsion to eat, but lately it doesn't feel like it really does much beyond that. So today, at 9 am, I took one of B's 10mg Adderall. Feeling a little bit foggy and kind of loose in my shoulders, but as far as ability to focus goes... my god, this is life with an easy button. I feel like I can just decide to work on something... that's it. I can just decide to do it, and then do it. I won't be watching myself constantly to make sure I don't wander off onto something else. I don't have to spend my day chastising myself for getting distracted.

It's just, hey, I think I'll write this program I've been sluggish about. Okay, that's done. I want to blog about this now, but first, I'm cold, I should feed the fire, and at first I stop and feel the fear and anxiety, if I stop to do that, will I get distracted and not come back to what I really want to do? But then, feeling so calm on this drug and I think, I can do that first and it will be all right, I can just stop and take care of something and I think, I'm pretty sure, I think I can come back to this first thing without wandering off onto something else.

It's when I'm on these drugs and they work that I realize how much of the finite pool of effort I have to use on everything in my life goes into just making sure I don't drift aimlessly all. the. time. I read studies about decision fatigue and, it finally makes sense why I just want to curl up in a ball and play a video game after finishing a tedious chore - nearly every productive minute of my day I'm alternating between cheering and castigating myself, keeping a running Tiger Mom chatter in my head - and sometimes out loud - to keep working. I repeat the name of the task like a mantra, give myself status reports, note milestones, but also chide myself for every temptation to pause and threaten myself with exaggerated consequences for failure. What I have to do, to put myself through, just to get the normal work of life done, it's horrible.

I used to have this recurring nightmare - it would be slightly different settings, but the principal was always the same - my personal favorite expression of it was that I was a kindergarten teacher leading a field trip through the paddocks of Jurassic Park. I'd try to keep the kids together, but I couldn't keep them all in sight all the time, as soon as one of them needed attention, another one would see something interesting, wander off just a little bit, and as soon as it was out of my reach, crack! a velociraptor would appear out of nowhere and snap the kiddo up. The raptors were always dashing in from the treeline to snag any children that separated themselves from the herd. Somehow, the supply of kindergarteners in my charge never dwindled (and oddly enough, the raptors never tried to get at the core group, but the point isn't ever that the raptors are after the core - it's the T-Rex that's coming for the core - it's that wherever the kids go, I have to vector after them. In other variants of this dream, there was an actual protective field or bubble around me, so in the space dream there was oxygen and livable conditions around me, but there were all the pretty stars that you could just barely see if you were right next to me, but that got brighter and clearer and spectacular if you moved just a little bit away... and then I'd move out, trying to keep up with you, but you'd keep moving and drift out into space and die horribly of asphyxiation and cold, and I'd get pulled this way and that and I couldn't protect you and I couldn't stay on course, I could only fail over and over again and watch you float away forever, stiff and frozen, with all the pretty, pretty stars).
yes, that Patrick Warburton

So I'm running through Jurassic Park with these extremely mobile toddlers who never seem to understand that they have to stay close or they will die. There are velociraptors that will get these children if I don't keep them all pointed in the right direction, and the T-Rex that chases us as I try to get us all safe to the base, and then, suddenly, blessedly, at the top of the next hill, there's Patrick Warburton, decked out like Rambo. He doesn't come down to us because that would be too easy, I have to run the kids up to him, but when we get there, he says "Don't worry, little lady. I've got you covered now. I'll watch the treeline for raptors, all you have to do is hold onto the kids and run for the base."

It is difficult to express how much, in the dream, my anxiety lifts. I no longer feel like giving up, sitting down, crying, just accepting that it is inevitable that we will not make it back, that we will all be eaten, that continuing on is simply self-punishment and insanity. Patrick Warburton, in all his burly, ammo-decked manliness, is here to put an end to the madness. All things are possible again. This can be done. I am in a state of pure and glorious relief, and then the T-Rex materializes behind my new hero and eats him in one bite, and the field trip and I are off and running again.

And that's pretty much what my experience of life with ADHD is like. Some days I don't worry about it, I let the kids check out the park and the stars and just kind of figure this is a "crunch all you want, we'll make more" kind of situation. The kids pull me with them, and we aren't going to get back to the base, but the T-Rex isn't bearing down on us right now, so what the hell, it's okay. And some other days, the base is in sight and it's so cool, the kids all run toward that on their own, and those are just the best days, ever. But most days I'm riding herd on suicidal toddlers with a T-Rex somewhere behind me.

Only now, at the top of the hill, Patrick Warburton is wearing a labcoat, and he's holding a bottle of Adderall. Hunky, hunky Adderall.

Friday, June 13, 2014

Reverting to Type

Met the new meds provider today - a psychiatric nurse practitioner who lists ADHD as a specialty - and I already feel like things are looking up. I think that with her we're going to find the right meds that will help me without taking things that matter away. I told her that being able to drop into "the zone" is very important to me, that I don't want that to go away, but (at least on days when the zone is elusive anyway) I want something that will curb the compulsiveness and impulsiveness and difficulty tolerating boredom, especially in the afternoons. For now, she's put me on a short-acting Ritalin. Next month, when the Strattera is good and gone from my system, we'll go ahead and start looking at Wellbutrin, Intuniv and Kapvay.

But here's the really cool part - to figure out what meds I'm most likely to respond well to, we did a cheek swab to send off for DNA typing! Apparently, somebody's figured out the markers for different enzyme productions (or just done this with predictive analytics) and from my cheek swab they're going to be able to generate a report that recommends which meds I have the enzymes to break down. Which is uber, uber cool!

In other excellent, excellent news, I found the zone again yesterday. It wasn't for very long - I had a timer set for an appointment I had to get to and that interrupted it - but it was the real thing. It had been far too long and finding it again was a tremendous relief.

Sunday, June 8, 2014

Back in the Saddle Again

It has now been a week since my last Strattera, and it's almost cleared out of my system. It's now unusual for my heart to feel like it's been replaced with a jackhammer, and my head isn't always a mass of clouds and pain. I got out today and spread some mulch for a while - there's no way I could have done that on the drug. There are many things that are getting better.

But there are things that are coming back that I was glad that the drug had done away with. A Bored Jennie is once again a Dangerous Jennie. No more placidly sitting through a dull meeting for me, we're back to wanting to stab myself in the leg with a ballpoint pen, just to make things interesting. And the compulsive eating is back (oooh! dopamine! my favorite!) I don't know if there's a right drug out there, something that lets me think and flow but which keeps the food cravings to a minimum and which lets me sit next to Ted from Airplane! without doing anybody harm.

If the answer was simply a matter of finding a great cheerleader though, the problem would already be solved. B has his shortcomings, but he keeps me reaching for my best. On Thursday, I participated in the Richmond Corporate 4-mile Race and he was there to be part of my company's cheering section. All I wanted in this race was not to finish last, and if I'd known beforehand how near a thing that would be, chances are I'd have skipped it entirely. For the last two miles, B walked with me and together, we were just ahead of only one other couple, and behind them, the police escort that marked the last of the "runners." I had my sunglasses pulled down and hoped that nobody could see me crying - it was utterly humiliating, and if B hadn't been there with me, I would have quit (which, incidentally, is what quite a few people behind us had already done, but that didn't make it any easier). I was beyond embarrassed, it was torture knowing that my co-workers were there to witness this, it was just awful when one of them was running back and forth between me and the finish line screaming "wooo!" it was an act of willpower to smile and look encouraged when all the "encouragement" did was make me feel even more pathetic, but the absolute worst, the hands-down, I-want-to-crawl-into-a-hole-and-never-come-out-again, just-get-me-a-muu-muu-and-we'll-call-it-a-life moment was when I did cross the finish line and the announcer called out my name and company over the loudspeaker, and then, a few seconds later, said "and that's all the runners!"

Yes, I suck. Thanks for noticing.

B and I walked back to the car together afterward. My legs were screaming at me. I was sobbing behind my glasses. I'd stopped caring if anybody saw. I was grateful I didn't run into anybody I knew, I couldn't have stood it anymore.

And then, B was perfect.

He told me, not that I'd tried my best or that at least I hadn't quit or that everything has a beginning. He told me that he was impressed. He reminded me that I'd been off the drug for only three days, that it had kept me from being able to do any training, any exercise at all really, for almost ten weeks, that before I'd been on the Strattera I'd have been able to knock that race out without a problem, and at a pace approaching four miles an hour instead of the two-point-something that I actually managed. He pointed out that when I had tried to exercise on the Strattera, I'd had to call for help because the elevated heart rate made my vision blur and made me feel like I was going to pass out. He said that only four days before, I'd tried to get a walk to prepare for the race and had to call him after only one mile, that that was a 400% improvement in only four days, and that that was extraordinary. He told me that I keep getting better all the time, and that's because I don't let setbacks keep me set back.

Saturday, I got out and walked again. Today, I spread a couple cubic yards of mulch around the yard.

So B's a keeper. But the Strattera is definitely out.

Tuesday, June 3, 2014

Having Lasted the Night

I have decided not to keep taking the Strattera. I've got an appointment with a new doc 10 days from now to do some new medication management, and we'll see what she says. But for now, still in the "just skipped a dose" range of getting off the stuff (but, ah, my foes, and, oh, my friends!) dear Lord, what it was doing to my body. This morning, I am exploring new territory in crushingly tired.

Wednesday, May 28, 2014

Can't Fight This Feeling

Humans pattern match - honestly, we overmatch, and why should that surprise us? There's a lot bigger evolutionary penalty for not recognizing that the way the bushes over there are moving means that there's a predator in them than there is for seeing predators everywhere. We pattern match ourselves into everything - not just anthropomorphism, but the tendency to see our own personal selves in vague descriptions, and the vaguer the better. Throw in too many details and what's described becomes unavoidably other (one of the best demonstrations of this I've ever seen is in Scott McCloud's Understanding Comics, an intriguing read on many levels).

Having said that, boy has this article (Adult ADHD: Devastated by Disapproval) about a fun little aspect of ADHD called "rejection-sensitive dysphoria" got my number:

In the long term, there are two personality outcomes. The person with ADHD becomes a people pleaser, always making sure that friends, acquaintances, and family approve of him. After years of constant vigilance, the ADHD person becomes a chameleon who has lost track of what she wants for her own life. Others find that the pain of failure is so bad that they refuse to try anything unless they are assured of a quick, easy, and complete success. Taking a chance is too big an emotional risk. Their lives remain stunted and limited.

For those of you who don't know us personally, the people pleaser would be me. B is the paralytic.