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...
"Take me out to the ball game..."
If you know me, you know that I'm a relatively short dude. But, I wouldn't say that I'm anything like abysmally short or seriously hindered in any way by it. I can still reach standard door handles and most other things on the tips of my toes but what I'm saying is I've never been formally asked to play on a basketball team, nor have I ever heard the saying "How's the weather up there?!" directed at me. And for some reason completely unbeknownst to me, I've always felt a certain seething offense towards the saying "tall, dark and handsome". It's probably because I'm neither tall nor dark. No, rather, the Lord saw fit to bless me with exactly 1,727.2 mm of vertical height to go about my daily business with. And despite sometimes being unable to reach things on the shelves of prejudiced cabinets, I think I've done pretty okay for myself.
In Part One, Stepping to the Plate was an overview of the condition, The Wind Ups was a recap of all the exciting stepping stones on the road to diagnosis, and The Pitches was a deeper look into the revelation of various medication and properly adjusting to their varying uses and side effects. But that really is only half the story, the greens of the meal, and part of the game. Part Two will tie them all together and possibly help to form some direction and a game plan. There's a connection that needs to be made between understanding each person's individual realities with the condition and then matching them with functional, logical ways to mitigate their impacts. To do this, I've laid out my own personal symptoms below- what they feel like and how I deal with them. If someone in your care is experiencing some of these things, this may help to provide some ideas and insight into what they're experiencing.
Believe me, learning how to control the condition is neither easy nor fun and involves some serious introspection and work. Yet, we all know that's why baseball players and athletes alike will train their bodies and practice for weeks, months and years to reach a final goal. This is a welcome sacrifice because the work gives value to the successful achievement of a goal and the goal inspires meaning in the work done to achieve it.
The Connection
"How, on God's green earth, did all of that relate to your own physical stature, Josh?"
I always use the height illustration because it works well for me to connect the dots with my brain's particular predicament. In our physical space at home, my knock-out of a wife will tell you that I love tidying things up into their places and having a nice, clean floor. So much so that when she asks me to clean the house (which, to any normal, functioning adult, that would mean mopping, sweeping and using that weird little brush everyone has to get in the cracks and crevices that are home to, no doubt, the things of our darkest nightmares), my mind assumes that tidying is the only thing she means and off I happily go, picking things up and putting them in their rightful places. Only then to be later met with a somewhat disapproving look. Obviously, this isn't an ADHD trait, I'm just a fan of cleaning...er...tidying! So I love physically organizing things yet, when it comes to my thoughts and headspace, I find it difficult, if not impossible, to organize things.
I use the tidying and height illustrations because I think of a brain with ADHD as a room filled with stuff. The stuff is strewn all over the floor and on the walls are all the empty shelves ready for the things to be placed on them. The catch is, the shelves for the things are just barely out of reach. For someone with the condition, the knowledge of how to put something on a shelf is there but the physical capability isn't. Medication and other forms of assistance aren't the entire answer because they're not cures, they're stepping stools. Obviously, being able to even reach the shelves is the first problem one needs to solve before tidying a space. So likewise, we need to connect the dots in our minds by being honest about what is hindering our scattered brains from cleaning up. Is that child really acting out because they're a calculated little tyrant and they just don't want to be better? Could be! Or is it more likely that they simply just lack the tools they need to tidy their space?
The reply to these thoughts might sound something like: "Well, maybe. But I can control my little Timmy. The symptoms aren't so bad! He threw a Molotov cocktail through a window, but only once. And that's saying a lot; it's not like he stormed the Washington Capitol!" While that may be true, and while I have no doubt that there are instances one may not need external help, it needs to still be understood that even with a mild case, there are still measurable biological differences in an ADHD brain that will manifest themselves in surprising, inconvenient ways. Maybe not as mildly inconvenient as a flaming bottle of Vodka, but still inconvenient! A brain with ADHD or other conditions is legitimately physically different, right down to brain structure, brain function and brain chemistry. Even still, I understand the apprehension to any form of external help. Be it medication, counseling, etc. It's new, often expensive, and there are poor reviews for things everywhere. Yet, at the very least, one needs to understand that there are physical barriers in play here that aren't just overcome by zealous willpower.
...work gives value to the successful achievement of a goal and the goal inspires meaning in the work done to achieve it.
If you like digging into the jargon and research of it all, I've linked a few interesting studies here:
Lancet Psychiatry: evidence was found that the amygdala and hippocampus, the areas responsible for emotional processing and impulsivity, are smaller in the brains of people with ADHD. These differences were found to be greater in children, and less so in adults.
The Journal of Psychiatry and Neuroscience, BMC Psychiatry: fMRI, PET and SPECT scans of multiple subjects showed evidence of decreased blood flow to certain prefrontal areas was prominent in brains with the condition. Decreased blood flow has severe impacts on those parts of the brain that control organizational skills, focus, planning, memory and emotional reactivity. Functional brain connectivity is often greatly impacted as well.
A Journal of Psychiatric Neuroscience and Therapeutics: our brains work on synapses, the space between neurons filled with neurotransmitters (messenger chemicals). In the ADHD brain, there is a dysregulation of certain neurotransmitters, meaning the messages can't be passed as efficiently or even at all. This is how stimulant medication helps an ADHD brain; it boosts chemical production/reception and restores the balance, allowing neurons to effectively communicate again.
As an aside, information can be found all over the web regarding medical conditions and various antidotes. Especially mental conditions. If looked up using certain phrases, many search results only feed confirmation biases. Avoid this, especially if you know you're doing it on purpose. Willful ignorance helps no one and "research" is not twenty minutes spent on your couch, two glasses of wine in, Googling things phrased in ways you already agree with. It's okay to read opinion pieces, but when forming concrete viewpoints, peer-reviewed articles must reign supreme.
I digress.
All this to say: what do? If medication and willpower aren't the full packages, but there's a clear biological issue and a clear need for decisive, ongoing action from a mature individual, how does such a person function? How do they use the tools, put the knowledge to work, connect with the pitch, and get the point?
The Point: Earned
So we have the tools, we have the diagnosis, and we have the will to make effective changes, now the work begins. What's the first step? How do we move forward? An individual with ADHD has to constantly expend effort to understand, sit still, and operate effectively (something that is twice as hard for a child whose general maturity and inhibitions aren't fully developed yet). We can speculate all day as to what may be going on in a particular mass of grey matter, but at some point, you as the individual or caretaker of the individual, need to make a choice in a course of action and follow through with it. Be honest with yourself and be consistent. Inconsistency, indecision and, consequently, inaction are the single greatest detriments to gaining any ground with this type of beast. Choose a path and walk it. If it doesn't work out, try something else. You've just read an entire blog post that may be describing you exactly, but again, how does one know where to start?
Two words: pragmatic honesty.
Lay it out for me. Answer these two questions:
What symptoms do I or the individual in my care honestly and consistently experience? Write those down.
What stimuli directly influences these particular symptoms, for better or worse? Write those down.
If you struggle with symptoms mentioned here, or if you work with someone who struggles with them, check out the table below. It's an in-depth breakdown of my own personal symptoms, the things I struggle with, what makes them worse and what makes them better, all rated on a scale of severity from 1-5. You'll see that there are things I have figured out and some I haven't. If you're going to start anywhere trying to control a learning inhibitor, start with the more severe symptoms first. The things that impact the daily functions like behaviour, school grades and relationships. We're all different, and by no means is there a coup de grâce that works for everyone. But there are common threads that can work well for different scenarios, we just have to resolve to do something about our situation and try them. Being educated about a particular condition is a great way to help mitigate symptoms when they rear their heads. When you do the work and earn your points, the crowd won't stay seated.
Feel absolutely free to utilize this chart in any way you see fit. These symptoms are not only annoying, but they're also overwhelming for those trying to truly understand them for the first time. ADHD isn't a curse or the worst possible thing to be shouldered with. Nor is it, by any stretch of the imagination, unbearable, untreatable, or uncontrollable. It's just a reality to learn about and deal with- hopefully, this chart can help you do just that.
Remember:
Inconsistency, indecision and, consequently, inaction are the single greatest detriments to gaining any ground...
The Crowd: Wild
I don't really go crazy for baseball. It's fun to play but I'm not the type that straps the tourniquet and takes a dose of it every hour. However, the analogies the sport offers for putting in the work are perfect. Earning RBI's in baseball is arguably more focused than other sports on each individual player's willingness to hone their skill with the ball. When you step to the plate, it's on you, not your teammates, to connect the bat with the pitch and run the bases like a bat out of hell. You are the one required to get the ball back to the infield quickly and accurately when the opposing team connects with a pitch. No one does these things for you, and no one is picking up your slack in those moments. And the wild crowd is part of the reward for a job well done.
Don't get me wrong here, this isn't Three Steps to Meet Your Financial Goals. And the "crowd" I'm speaking of isn't about fame, success and a Major League salary. The crowd is our wives and husbands. Our kids, our friends, our church family. Even that obscure uncle that always gets political about everything. Maybe especially him. If we're interested in becoming a person that these people can count on and respect, we need to get our hands dirty. Don't avoid confronting this condition or one that causes symptoms like it. Like I said, it's not impossible. But piling things in the corner year after year when there are shelves on the wall for them eventually just becomes lazy housekeeping. If you know you have a mental tree in the road and choose to avoid the help you need to restore traffic flow, that's on you, not the tree, and not the other motorists. The human experience is wasted on those deciding they have no improvements left to do because improvements are inherently painful.
- "Hey, you look like you're in trouble, can I help you? I've got a chainsaw in the trunk!"
- "No thanks! Chainsaws are a hoax! #cancelchainsaws!"
The people in your life need you to arrive, to be present and to do life with them. We can't do this by resigning to our blockages, letting the pitch hit us, or canceling the figurative chainsaws available to us.
I am obligated to mention the same disclaimer as in Part One, though: remember that there are often cases in which one can't just decide to fix. These are precisely the cases in which we are to offer minimal suggestion and maximum support. We never know what battle someone is fighting, but being there for them and rallying behind them when they try to sweep the floor is paramount. Opportunities for support are so regularly lost on those trying to fix problems with quick solutions; so strive to be a handrail, not the entire staircase.
Remember, to be successful, this will take the knowledge, the willpower, the right tools, the pragmatic pursuit of results, and certainly a whole lot of patience to grease the gears between them all. Our best work can always utilize the newest thing we've learned.
And even if you've swung and missed hundreds of times, there's always another pitch.