Friday, December 4, 2009

Oh gee, not AGAIN

Okay basically my medications are working. I think. I mean when I take them together, all the time, things are okay. But there's this funny problem...Remeron/Mirtazapine makes me REALLY GROGGY. Which is okay when I am taking the Vyvanse, which perks a person up rather nicely (even while calming the brain). But there are days when I don't really need to take a stimulant...and I HAVE to because otherwise I will sleep all day. I'm honestly a little annoyed with my prescriber right now because YES, I get it, he is probably used to working with people who are a little less meticulous about self-reflection and a little more likely to give in to ADHD impatience. I'm not one of those people, I have a pretty good idea of when I'm being driven by impulse and when I've really analyzed the criteria and am making a reasonable request.

I analyzed these criteria months ago when I started the Remeron...this is a known side effect that should have gone away by now. It is not typically an issue, because I like taking my stimulant most of the time anyway, and the days when I choose not to take it are ones where I don't really need to think. But yesterday, I forgot to take the stimulant...and was SCREWED at work. I was fighting to stay awake all was awful. I'm just lucky I was at the job where I don't need to be "on" all the time.

When I called him he said "oh...just take it in the evening". I already do. So he said "oh. Take it earlier in the evening". I said "I get what you're saying, but if you look at this logically, it's 6pm right now as I'm talking to you...I should not still be THIS groggy and I have been THIS groggy all day". He said "okay, I hear you, just try it and call me next week and it it's still a problem we'll try something else".

UUUUUUUUUUUUUGGGGGGGGGGGGGGGGGGGHHHHHHHHH. Oh I'm going to try it. I'm going to do it to the LETTER because there's no way in hell I'm going to have him disagree with me next week.

Last night, as instructed, I took the medication two hours earlier, AND went to bed earlier, just to make damned sure that lack of sleep wasn't part of the problem. I could hardly wake up this morning and instead of taking the Vyvanse, I went to work without it because of course, if I take the stimulant I won't be able to tell if I'm still groggy from the Remeron. My boss come into the office and asks me if I'm popping, I am NOT JOKING. When I say groggy, I mean god damned groggy. I was working not to slur and struggling to stay away. I waited until two hours after I'd woken up and took the Vyvanse...which takes another 40 minutes to kick in, which means I lost an entire morning before I could even sort of function at work.


We're trying something else cowboy. I have way too much at stake, and WAY too much to catch up on due to medication drama earlier this year, to be knocked out like that!

I am beginning to wonder if the Vyvanse is actually doing what I need it to do, or if I'm just so relieved to cut through the fog of the Remeron that I'm giving it way too much credit. To the Remeron's credit, it sure gets rids of my anxiety!

It is true that while the Vyvanse makes me very effective at getting some things done, I am still struggling at some things...although when you look at it...I am able to focus damned well on things I enjoy, even more so then when I wasn't taking it...before I started taking it even if I enjoyed something I would be distracted still. Now...if I like something I can do it for hours. But if I don't...I'm even less likely to do it. Because I am so able to focus on the things I like...ugh...that damn line between "is this med working" and "oh, I need to pull my head out of my ass and do some boring crap right now" is sooooo thin...too thin...which I guess is why ADHD is a disorder, not a "gift"....

Thursday, December 3, 2009

Do I Get A Brownie Badge?

Yesterday at one of my last classes for the semester (really one of my last EVER in grad school) I overheard a first-semester student lamenting to another student "There is no way I am going to pass this semester. I don't know what happened...I just couldn't handle it. I don't know what to do...maybe I should talk to my professors? I don't know how to tell them what went wrong because I don't know. I have ADHD and dyslexia but it doesn't seem like it should have been this hard and I think I'm going to have to drop out of the program...".

BEEP! Wait, stop right there, did someone say "I can't handle grad school because I have ADHD and dyslexia"!?

Just so happens that I am a shameless interrupter, and so I walked up to her and said "I'm sorry, but I was totally eavesdropping and I just want to tell you: you can do this".

She looked really a little startled.

I told her: "This is my last semester and I was just diagnosed with ADHD earlier this year. It really sucked sometimes but I did it. In fact I did it with a 3.8. I basically had a melt down at some point in every semester but you know passes."

She said "I totally had a melt down weeks ago but I didn't tell anyone...I just felt so dumb. "

So I asked her what parts she was having a hard time with and we talked for a long time. Predictably she had a lot of difficulty with reading. I know that the same strategies won't work for everyone but I told her what worked for me, so while I'm in the business of recounting this tale, I'll map out my strategies here, like I did for her:

1) In grad school, it's highly unlikely that anyone's going to quiz you about idiotic little details. So do you have to read all of those heinous articles word for word? Hell no. If reading is as shitty for you as it is for me, print out the article pull out a highlighter and use it to read and highlight just the first and last sentence of every paragraph. Occasionally this might help you get sucked into the reading, but even if it doesn't it will give you the overview so you can keep up with the discussions.

2) Don't stress over the stuff you hate...use tricks like the above to keep yourself moving forward until you get to the next oasis of a project that actually interests you where you can hyperfocus to your hearts content.

3) Communicate with people. If you're having a hard time with your classes, talk to your profs or your advisor about it. They may be able to help you strategize, or connect you with people who CAN help you with that if they just don't know what to do or say to help you. To my surprise, when I was having a hard time this semester, because of medication problems, I discovered that BOTH of my professors this semester had psych issues of their own and knew exactly what I was going through with meds not working correctly. Which brings me to 4...

4) Don't assume you're the only one with these issues. You're not! Hooray! Doesn't it lighten the load just knowing that nobody else is normal either? Does for me...makes me see the world as "us and us" not "us and them".

5) If you're having a hard time with a group assignment, let your professor know or if you're comfortable just talking to your group mates about it, then do that. If you have a hard time with some part of the assignment, maybe you can request to work on a part that plays to your strengths?

6) Use your early enthusiasm to your advantage. I pick my topics for the semester's projects on the first day of class and then spend the next 2 weeks blowing my wad looking for articles for those projects and putting them in a folder so that a few weeks down the road when I'm verging on a melt-down I can talk myself off the ledge with "oh yeah...shit, I really don't want to do this assignment but I already dug up all the articles"...makes it WAY easier to plan and to get work done as the semester wears on (and oh, how they wear on...).

Do you know how good it felt to be able to say to someone "Hey, I went through this shitty experience and I survived and YOU CAN TOO.". Do you have any idea how nice it would have been to hear those same words from someone else when I was at the end of MY first semester having a total melt down? It brings tears to my eyes just thinking about it. And do you know how nice it was seeing HER face literally relax as we talked and light up when I said again, before I left (leaving her with my email address in case she needs melt down support down the road): YOU CAN DO THIS.

And she can :)

Treatment has turned me into a slacker

Michele's comment on my previous post reminded me that I wanted to talk about this issue...I am a big slacker since I started ADHD treatment. While I suck at doing anything in a routine way, I am very rigid and uncompromising in getting my "work" done, because I know if I slack off, that I will likely not finish things. Well, treatment is making me way more laid back. The drugs calm and focus me, and the anxiety of my unfocused mind (combined with a little extra helping of anxiety that I seem to naturally harbor) were the horses driving my engine.

If I can't stop thinking about doing a particular project, I will stay up however late to get it done, even if I will feel like crap the next day, because I fear the not-finishing so much. I still do this but not to the same degree.

This just cracks me up because so many of us go to treatment because we want to be "more productive". However, I am realizing that this elusive "being more productive" was not really a good treatment goal for me. And honestly, when my therapist made me try to verbalise my treatment goal, I didn't say I wanted to be more productive, I said that I wanted to learn new skills to live my life, to replace some of the ones that weren't working.

If you measured me pre-treatment in terms of output, my life was working. If you measured me in terms of true mental health, probably not so much...I mean can you really say your life is working when you're fueled by desperation, fear and anxiety...even if the outcome is a lot of output? And I won't claim that I was working efficiently.

If I had to say what I am getting from treatment, I would say that yes, I am learning to be healthier, yes, I am learning to live my life in better ways, but am I more productive? I don't really feel like I am. Is this a problem? I don't know yet. I mean due to the fact that I was able to accomplish as much as I was unmedicated, it's possible (okay okay, it's TRUE) that my expectations for what a person should be able to produce are a little off. A little unrealistic...and over time, probably a little suicidal. But the fact remains that I can't DO as much as I did before and yes, that bothers me.

I don't feel that I am being impaired though...just that I had (and still have) no true grasp of what is a reasonable amount to pack into one day. I still don't know what that looks like.

Here's how I know that I am making "progress". I went to class yesterday for the first time in person since starting this medication combo. (Online class, meets infrequently in person.). Sitting there was absolutely a different experience. I was able to sit there a LOT longer without feeling like I needed to leave the room. The presentation we were watching was objectively boring so I know that the "normal" brains in the room were struggling as much as I was. There's a certain urgency, irritability and frustration that I always feel when I'm stuck at a desk in a classroom and I did NOT have that feeling. It was SO peaceful. I have the same experience in meetings and I LOVE it. I love being able to tolerate normal life situations without the well of anxiety building up in my body and mind because I just can't stand it anymore.

I am buzzing around less because I'm wasting less time on the jackassery of ADHD disorganization. I spend 10 minutes a week cleaning out my purse, which saves me a lot of time later that would have been spent looking for lost stuff in it, or cleaning a bigger mess out a year from now.

Most of my "piles" are gone and have not rebuilt themselves--and I had at least ten years worth of high-quality "WTF!?" built up in those piles.

I got some portable DRAWERS to put my clothes in. Don't worry, I haven't lost my mind, I'm not going to you know, fold laundry or anything but I found some that are wide, and CLEAR so I can see what's in them and they are portable so I can move them around if I want to.

It is easier to not overcommit myself. This will be an ongoing struggle but I just don't have to fight as hard to say no it seems.

And in regard to saying no, I did NOT engage in any "extracurricular" activities with said "date" last night, at ALL. Hey now...I'm not saying I'm usually a big town bicycle or anything...just that ADHD impulsivity has aided me in many a romantic misadventure in the past.

So while treatment has given me nothing but progress, progress for me just looks a lot different than one might expect. I like it, but it takes some getting used to. Makes it really easy to see how someone with certain manifestations of ADHD could be mistaken for bipolar at a first glance...happens all the time.

Tuesday, December 1, 2009

The Hallmark of the Adult ADHDer

There are a lot of people out there running around these days saying things like "oh, I must have ADHD because I change the tv channels a lot" or "gee, I am bored all the time at work so I must have ADHD".

I think I have found the foolproof measure of if someone is, in fact, and adult ADHDer. And this marks my first foray into the type of blogpost I find most annoying in the ADHD blog genre: the "this is true of me as an ADHDer so it must be true of everyone" post.

Back to the task at hand and enough of the meta-analysis...this it goes beyond distraction, irritability, impulsiveness, forgetfulness. Technically it falls under the category of "impairment" as a symptom, but it's so much more aggravating than that.

Sustaining of routines...the proof is in the difficulty sustaining routines. I swear to God...see, if you have a normal brain, and you have a problem with being bored, you can easily address that with a few weeks of therapy and signing up for a new cooking class. If your problem is boredom at work, and you have a normal brain, again, a few weeks of therapy and a new perspective or a new JOB should fix the problem and show you the way for what you may need to do if you run into this problem again.

If you have ADHD and you are always bored...and you seek new will seek MORE new activities and more and are heading down the road to compulsively seeking new activities. I'm not talking about people who just like to try new things, ohhhh noooo. I'm talking about people like me who cannot simply do one thing at a time, but also cannot say no, and end up overcommitted before they have even realized they are busy in the first place. It's a bit of a drug. It's exhausting. It leaves you in a state of constant frazzle that no normal brain would ever allow a person to achieve, but which the ADHD brain requires! Alright, alright, which MY ADHD brain requires.

If you have ADHD and you are bored at work, a new job will never fix the problem, because you will eventually (and probably quickly) become bored at the next one. You leave and find a new one before you even learn how to work through the problem, over and over and over (or get fired over and over and over) never learn to break the cycle because you can't. Even if you go to a therapist and they don't figure out your problem is ADHD for years (um, hi, that would be me again) you might learn how to have terrific insight, how to manage your anxiety and frustration somewhat but you have NO idea how to actually address the actual problem. You remain anxious, frustrated and bored!

This lack of routine exists despite our actual symptoms it seems...if we had a terrific ability to cultivate routines, we would not be impaired and hence would not need a diagnosis.

Now then, let's discuss some of my common ADHDer challenges, their solutions, and then the REAL reason that I can prove I'm an ADHDer: the imperfection of those solutions, and why they are imperfect.

ADHDer issue #1: remembering to take medication, or as Hallowell/Ratey say "how to remember to take the pills that help you remember to take the pills". I have this great donut shaped thing with the days of the week on it that helps me to remember to take the pills. When I remember to look at the donut shaped thing. I was on a roll for a while, but in classic ADHDer fashion, once I fall off the wagon, I fall hard and have to shoot myself in the ass a few times before I am able to get back on track. I'm in the middle of getting on track with this after a rousing round or two of "wait, did I take it? did I not take it? I don't think I took it...but can't take it now because if I already took it I'll freaking OD...". I don't know when I fell off the wagon but it probably had something to do with me having a moment of anxiety about having one more thing to remember to do and ended up here. It seems like there should be an easy way to fix this...but there's not. I am just going to have to fall on my ass a couple more times, then it will move to the top of the list in my brain again and I'll be okay for a while. The ADHDer brain only has an extremely limited amount of RAM you see, therefore, once anything is added to the queue everything else shuffles and it ain't pretty. Something will have to fall off the list...the pill donut, for the moment, is the thing that fell off the list. The therapist asked me where I put it...I didn't know...I don't even know the moment that I stopped using it. Kind of like when you throw a ball for a dog and it doesn't quite see where it went so it just keeps running...or sort of runs in the direction of the ball and runs back to you without the ball and you're like "dude, dog, I can't throw it again if you don't bring it" and the dog stares at you because he has no freaking clue where the ball went. The trick is to find a really clever way to get the dog to go back and get the ball. Wait maybe the trick is to just go and pick up the ball. Uh....

ADHDer issue #2: I had a system for doing homework. My system got thrown off. I am totally floundering. Might sound like OCD but it's not really like that. It's not that I have to complete a certain ritual, like with OCD, it's that once my routine is thrown off, re-establishing it is a monstrously huge undertaking. ADHD is the crack in the record that makes the needle keep skipping, and MAN, is that every annoying in the middle of the song. Changes in routine fuck me up, big time, every time and honestly I'm not sure how I'm going to get through this finals week. I keep resetting the needle but the flow just isn't happening.

ADHDer issue #3: turning in my time sheet at work. Something about filling in those little boxes just makes my head scream. This task makes me almost descend into an actual temper tantrum. A while back I started doing it two days early because that helped me to get it done. It was either early, or not at all...well there was a holiday on a Monday one week. ARGGGGGH! I have not been able to reset the routine since then. NORMAL PEOPLE DO NOT HAVE THESE PROBLEMS. Yes yes, I know, put it on a calendar, blah blah fucking blah, I don't want to hear it, I've set timers, I've put in on the calendar...I'm just going to have to figure out how to sort it out on my own. Somehow. Somehow that doesn't involve my mind literally growing instant wings and taking flight at each separate box. Wonder why ADHDers are irritable, that's why, imagine spending all that energy literally trying to pull your mind towards you, several times a minute to complete a simple task, a task that your logical mind actually understands is not difficult, which makes it that much more frustrating that you can't anchor your mind to do it...

There's so many more...but the dividing line for ME between the capabilities of my ADHD mind and those of normal brains, always lies right there along the frontiers of routine. And after several months of relative improvement I'm not going to lie, it's annoying as heck to find myself stuck again trying to re-figure out how to get the same things done. Overall I think this is THE most annoying symptom for me. I mean crap, I'm sitting here and I can SEE the problem. I can SEE it. My self-awareness is the damn reason I went in for evaluation...but the other reason I went in for evaluation was that there was indeed nothing logical I could do to "fix" myself. Medication has closed some of the gaps between logic and ADHD for me, but not all of them. And the realization is crystal clear at the moment that life is always going to be like that...and man, that's a fantastic (insert sarcasm here) notion to re-visit...over and over...and over...and over...and over and over...

I'm going to go grab that pill donut RIGHT now and put it in a really visible place. OH...I just realized why I've been hiding it. From the dog. Got a new dog. Right. Now I remember. Yes, I seriously just remembered that, just this very minute.

Out of sight, out of mind could not be a more literal issue for me.

Sunday, November 29, 2009

Gotta Do Watcha Gotta Do

After a well-intentioned but misguided attempt at "breaking my dog in" regarding a holiday parade...with loud fire engines...and scaring him half to death (he was just barely peeking out of my coat...good thing he only weighs 3 lbs)...I have returned home with a single mission and purpose. To get this last semester of school OFF MY ASS and out of my life for good.

I have traded water for beer, thus trading homework quality for homework quantity...and I don't care what it takes. If it takes an all-nighter, fine. If it takes another beer or two...FINE. If it takes leaving work at noon tomorrow to get 'er done...FINE. I have had this semester up to here (imagine short girl with hand stretched over her head indicating also short, but slightly taller status, holding a 3 lb Chihuahua).

The puppy is busy with his rawhide, the cats are settled in to observe.

Swig...log out of blogger...

The Score

I'm sitting here feeling frustrated about my semester, because I'm so wigged out about finishing everything I need to finish this week for school. So I'm making a list of all the non-ADHD obstacles that I have contended with in the last few months. I'm doing this because I am in the middle of a really big first year of ADHD treatment, and sometimes I have so many other obstacles that is makes it hard to see that I have actually made a lot of progress:

1) Started the semester off with the hellish experience with that particularly awful batch of generic Celexa. This shot my entire routine for the semester in the ass and I'm still recovering.

2) Family business hit a serious road-bump and required all hands on deck.

3) Was working to finish off producing my weekly event for the season...and greater than anticipated success created a lot of work.

4) Ended relationship with the boyfriend...due to his bad habit of sucking energy out of my body with his insecurity. This disrupted not only my life, but my home as well, as he took his sweet time moving out.

5) The check debacle (see previous post).

And add to that list "working to learn to live a new life by treating my ADHD". Oh gee, I wonder why this semester has been such a challenge! Any person with any kind of brain would be having a challenging time managing all of this while in grad school...and the big positive throughline is that during all of this I have been tenacious in practicing removal of anxiety from my life, rather than giving in to it and letting it run the show. Not the ignoring and tolerating of it that I used to do...actual letting it go. I'm going to crank on a homework marathon so I can then compile the list of "what I got done that was awesome" this semester and add "homework" to that list.