A comprehensive walkthrough of my experience with ADHD.
Disclaimer
This post is dear to my heart and much time was spent making sure it was delivered correctly with current information and real experiences. It is playful but also honest about the dark side of emotions this condition can bring about. There's a lot here so it will be released in two parts.
I am neither an MD nor am I qualified to give pharmaceutical direction. I have exactly no more than zero credentials in Behavioural Analysis, Cognitive Behavioural Therapy, or other related fields of study. If you are experiencing any of the symptoms or scenarios I describe here, please reach out to me, though in the end, I will always suggest qualified testing be done by a specialist. That's what I did and doctors aren't half as scary as you think. I've also been able to work through some of the same symptoms with others in ways that have helped, but that does not mean I am qualified to give an official diagnosis. This blog post will be a reflection on my particular situation and what works and doesn't work for me in the hopes that you'll find what works and doesn't work for you.
Also, this post may be a bit scattered and hard to follow.
For obvious reasons...
Stepping to the Plate
As with any meal, I suppose one generally starts with a salad and some mixed vegetables. Of which the children cry with forks in hand and parents bemoan and it's all just an awful and treacherous business. Nonetheless, the Great I AM saw fit to include those pesky vitamins found in leafy greens and deep-coloured veggies as part of a well-rounded, healthy diet. I'll try to serve up some literary greens by sharing a backstory on the condition before we get into the meat and potatoes.
The widely misunderstood ADHD, or Attention Deficit Hyperactivity Disorder, affects an increasingly staggering amount of children and adults per year globally and has a colourful palette of symptoms, treatment options and naming history. Once awesomely coined Hyperkinetic Impulse Disorder, it became widely known as ADD for many years (a now-outdated term once used to describe a type of ADHD in which the person does not exhibit hyperactivity or impulsivity, known as Inattentive-Type ADHD). Attention Deficit Hyperactivity Disorder is now the current medical term for the disorder, with a few underlying sub-categories. Once thought to simply be a product of too much leisure and too few spankings, the behavioural phenomenon was first mentioned in 1902 by whom I am convinced was a fine, respectable, British chap named Sir George Still. Our knight in polished, pediatrician's armour characterized the curious condition as "an abnormal defect of moral control in children." And the lad wasn't far off the mark, despite his presumption that my particular personality is 'defective'. Because you see, my main man George observed that, while the affected children could not control their behaviour for some reason, luckily despite that, it seemed that "they were still somewhat intelligent"! Bully for us, I say! Cheerio and many thanks for the vote, George! Anyways, legend has it that sixty short, dismally uneventful years later, ADHD was granted its official recognition by the American Psychiatric Association.
Now, since its establishment in the '60s, many more statistics and symptom data sets have been collected by organizations like the CDC and NHS among others. This data shows that those diagnosed with ADHD can often cozy up to other disorders including anxiety, depression, ASD and Tourette's syndrome. Of course, this is apart from the usual suspects of inattention, distraction, and the aggressive appreciation for scurrying, furry friends. The condition is brought to us and made mostly possible through the generous sponsorship of genetics, everyone's favourite fall-guy for the varying spices of life. Furthermore, ADHD is most popularly thought to be caused by an imbalance in various chemicals and the level of neurotransmitters in the brain as a whole. Treatment of the still-unestablished condition began with the commonly-known drug Ritalin (methylphenidate) in the ’50s, though many other more effective options like Concerta, Strattera, Vyvanse, Andhansia, etc. were eventually approved for use.
A more detailed list of symptoms are as follows:
short attention span, easily distracted
constant careless mistakes
extremely forgetful and unable to remember basic tasks- e.g. losing things
being unable to stick to tasks that are tedious or time-consuming
appearing to be unable to listen to or carry out instructions
constantly changing activities or tasks, difficulty organizing and concentrating on tasks
being unable to sit still, especially in calm or quiet surroundings
constantly fidgeting
excitability and extroverted tendencies
excessive physical movement
excessive talking
being unable to wait their turn
acting without thinking
interrupting conversations
little or no sense of danger
To sum up its capabilities, ADHD allows one to confidently go somewhere while reliably forgetting all of the reasons why they've embarked in the first place. It allows one to sing the lyrics of a song they heard a single time while simultaneously forgetting to put shoes on as they leave the house. It keeps a certain sentence stuck in your head on repeat for weeks, but it lets basic information you literally just heard slip through the cracks. All in all, Attention Deficit Hyperactivity Disorder and the entirety of its sub-categories, may well be, arguably, one of the most exciting, infuriating, interesting, frustrating, life-changing, misunderstood neurodevelopmental disorders on tap for us humans. And it is a very real condition. Many think that it's just a lack of self-control or allowing fewer stimuli. There are elements of these things that can further exacerbate symptoms which I'll talk about in Part Two, but, if you find yourself naysaying the notion that such a condition exists, you are mistaken. In any particular application, it can wreak havoc on work and relationships while bouts of depression and social anxiety are peppered in for some extra flavour. Don't let that discourage you though. Flip the coin around and ADHD can deeply brighten one's personality with a steady stream of positive endorphin rainbows shooting out the ends of their fingertips. The catch is, and what one with the condition needs to learn to anticipate and control, is that it can swing from one of these extremes to the other within a couple of minutes.
As an adult with ADHD, here's the story so far and how I learned to deal with it.
The Wind Ups
I was diagnosed with clinical ADHD when I was young and have been wrestling with it for as long as I can remember. It's pretty cliché that I'm writing about it, but the condition is a fascinating one and I feel as though you can have some fun with it while learning about its darker sides. I really don't remember a time when I wasn't fidgeting or feeling the way I currently do. My earliest memories in elementary school are just a lot of memories of acting out in class and not a lot of memories about the curriculum's content. I felt like I was driven by a diesel engine, driving faster than the speed limit to who knows where. And I was usually the villain in the story. Because of my disruptions, every day I felt like I was the possible cause for others' poor grades and giving the teachers their premature greys. Even when I badly wanted to sit still, something would catch my eye and off I'd go as if on autopilot. My mom tried all kinds of things, but it seemed like nothing worked and I kept right on my merry, crazy way. She was patient though, and that was the catalyst in a reaction that changed the game for me.
I should add: to the moms and dads, especially the single parents, that deal with what mine did, you are more than heroes. My mother was a warrior and a champion through this. She walked with me through this every step of the way. It was she that dealt with the brunt of my learning this new struggle in myself and it was she that helped guide much of the process for me. I owe her so much for that and even though I don't have kids yet, much less a kid that's diagnosed, I can attest that you are changing your child's life right now by being there for them - even if it doesn't seem that way and even if you're only just keeping them alive today - it's extraordinary what you are doing. Please don't give up, these kids need someone to walk with them. To take a page from my own mom's book, do your very best to be patient and easy on them. Hard, fast approaches will end in disaster. Shaming, belittling and statements like: "What did you think was going to happen?! You know better than that! What were you thinking?" are perfect recipes for trashed self-esteem when they're older. I guarantee you that they know better, even at these young ages, but they are physically incapable of acting on this knowledge. I assure you, they will have plenty of people say these exact things to them in their lifetime but you are the port in their storm. Be the calm that they are desperately seeking. I can't thank my mom enough for speaking calmly to me when I was acting out; what a monumentally profound impact she had. ADHD kids have cool brains, please just take the time to see that and enable them differently.
...to the moms and dads, especially the single parents, that deal with what mine did, you are more than heroes...it's extraordinary.
So, on to mini Josh. I was eventually introduced to spectrum testing through our family doctor and we set off on the path of diagnoses. The testing involved multiple appointments, exams and written observation tests, but I never saw any of the processes as an inconvenience or embarrassment. However, I'd be doing a great disservice to not mention the duality of emotion as the testing came to a close and the diagnoses loomed ahead. Especially for a young boy that was taking his first run at this whole proposition of being different. On one hand, I saw the prospect of this ordeal as a superpower. I thought that this was a way I could win more recess time and less classroom time. I could avoid my chores at home "...because I just wouldn't be able to focus enough to do a good job, mom!". Much to my dismay, it only earned me more detention instead of either of the two previous options, and I did the same amount of chores. Maybe more. So, that was on one hand. On the other, once it sunk into my mind that I had something out of the ordinary to deal with, that I might have to medicate, and that I'd continue being the villain until control was learned, it became a mental sandstorm.
Then there was the bullying: with a bad set of British teeth to go along with a bad temper, I was prime pickings for some bad attention. You know, from the inane schoolyard bully type. Once it got around to the Mount Salem and Aylmer Ontario Greatest of All Time Best of the Elite Jocks Club of Y2K that I was being tested for "some kind of condition" and that I needed medication to "pretend to be normal", recess got more colourful than our early-2000's wardrobes. Yet, jokes aside, since I couldn't change what was happening to me, I'm ashamed to say that I turned it into the vicious cycle of giving as good as I got. Dear Reader, know that, if you're working with a child that's been openly diagnosed with any condition, despite the current efforts in schools to remove the stigma around such conditions, they are dealing with some very real feelings being even slightly different and the fact that some kids are talking about it. Please take steps to process that with them so they don't become a bully themselves as I did. Because of that, I always say that my tale is a cautionary one- I carry some serious regrets with me for deeply hurting people that I really cared about. My temper and tendencies to aggressively protect my own insecurities were utilized purely so I could feel better about myself, nothing more. They were mistakes of epic proportions and I often gave "full vent to the spirit"- only a fool does such a thing. Please remember that high emotional tension and low grades are a powder keg waiting to manifest in a sizeable helping of issues down the road that usually causes pain for other people- especially the ones closest to us. One spark lights the fuse that can have lasting repercussions opposite the desired effect.
I wanted so badly to be able to understand myself and be better. But while it's important that I wanted to, that will-power was only me, having stepped to the plate, getting ready for the pitches.
The Pitches
The next number in the equation was formal diagnoses and the proposition of medication. Since by now my mother and I both knew I had something that required more attention to understand, we were not against the idea of medicating and after going over it with me, she gave the family doctor the go-ahead to start trying various options. Controversially, I can't stress this next part enough: correctly and carefully medicating with accurate dosages has undoubtedly been the reason I function at all. If you've spoken with me about ADHD, you'll know I'm an avid proponent of medicating within reason. I started with Ritalin, shot up to the highest dose possible for my age category with Concerta, and am now on a mid-level dosage of Vyvanse. At every step with every different type of medication, there was a notable difference in both my ability to function in learning environments and my ability to emotionally process negative and positive stimuli. I specifically remember a time in the car on the way home from elementary school when my mom checked in with how I was feeling on Concerta. I remember the profound feeling and voiced to her that for once, "I didn't feel like the bad guy anymore". Read that again.
Correctly and carefully medicating with accurate dosages has undoubtedly been the reason I function at all.
Note that some medications will absolutely not work for various people. It really is a journey. For example, Ritalin didn't end up being for me. While it definitely helped me focus in school, it increased my anxiety over the smallest things. My temper was even shorter and I felt like my heart was pounding constantly. Many of these drugs are actually stimulants so dosage always starts out small and usually works by increasing norepinephrine and dopamine levels in your brain. This helps to balance out that disproportioned chemical cocktail in the ADHD brain and allows focus to be selective (not necessarily always controllable), rather than scattered. This ends up stabilizing moods and overall symptoms as a result. However, if the dose is released too quickly, sides effects like a racing heart and shortness of breath can happen. There are always some side effects either way, and this is an understandable hang-up that many have about medicating. Not all side effects are evil, but they range from unnoticeable to mildly irritating to concerning. While we decided to move to Concerta (a slow-release, slightly more advanced version of Ritalin), I mostly experienced a loss of appetite and didn't ever really eat food during the day. I had breakfast and supper, but nothing in between. This wasn't a big deal but resulted in me being small for my age- hello sandwich and generally ill-placed appetite comments! (Just kidding, they weren't that bad. However, for some, keep in mind that this side effect could domino into an eating disorder if not checked and maintained properly.) Aside from that, I hadn't noticed much on Concerta so we decided to make it permanent. Keep an eye out for those racing heart or shortness of breath tells I mentioned- like the ones I experienced on Ritalin. These can cause less than ideal situations and pose health risks if not addressed.
In my late twenties, I started experiencing these effects on Concerta as well and, based on consultation with my doctor, I switched to Vyvanse. I have found it to be much more advanced compared to previous options. On Concerta or Ritalin, my brain was basically locked into a state of focus which can result in hyperfocus on things that aren't immediately pressing, a classic ADHD symptom. On Vyvanse, however, I find that I have the choice to decide what to focus on and when to turn that focus on or off. For me, it's a much more organic experience and I like the feeling of control I have over my head. Again, I'm on a mid-level dose of it and have not experienced it as a kid- make sure you consult your doctor and start slow with doses.
My point here? This journey is a fluid one. It's not always linear. And we should be ready for changes and quick adjustments. Because despite my experiences with varying side effects, upon finding the medication that worked, I still verbalized that "I don't feel like the bad guy anymore", and I think that was the first sign that we were moving in the right direction. This certainly wasn't the end for me though. I still bounced off the walls and chased squirrels, but for the first time, I felt like I could see the path towards controlling it.
The Seventh Inning Stretch
It's important to understand that while any type of condition comes with its own obvious set of struggles, it also carries a ton of responsibilities. While that may seem like an obvious statement, I find the general outlook, after diagnosis and assistance of various kinds are offered and implemented, is that the box should be checked and the individual and everyone surrounding them can just get on with their lives. "Job well-done, mate!", right?
Unfortunately, medication, assisted learning, and any other type of aids aren't silver bullets, be-alls, end-alls, or checkmarks in boxes. Anyone, with any kind of reality, anxiety or quirk that affects their daily lives and relationships is responsible for them. Don't get me wrong here. Obviously there are outliers to that statement, I understand that. There are all kinds of circumstances that require external assistance for the life of the individual- that's not what I'm addressing here. Severe conditions aren't remedied with broad statements such as these and we should be greatly cautioned against offering some sort of low-effort, quick-fix answer to the questions life may ask others but does not ask us. My point here is that while not every condition can be fixed permanently, a great deal of them can be managed practically. Pragmatic introspection is difficult and it's uncomfortable, but that's just it: one needs to be willing to accept that, if they're mentally capable, they are responsible for tidying the mental space and sweeping the floors. We should be encouraged, implored and driven to address our various mental states by setting in motion without delay the measures we can take to address them. Again, if there are deeper issues at play, external help may be the required avenue and we should always rally behind those seeking a professional housekeeper to help tidy their mental space. We do this for the good of those around us and we do this for ourselves and the functioning ability to share our lives with those we love. This is the human experience and far too many are robbed of it because we fail to sweep the floors.
To be continued.
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