Some Personal Thoughts

This blog was designed to provide information but I think it's also important to provide personal reactions so that when other people read it it might resonate with people who are dealing with ADD, testing, or diagnosis. So here are some personal thoughts. They are from a longer essay, edited for legnth and identifying features. That's why it sounds disjointed.

I am part of a growing number of students and adults who are diagnosed post-childhood because, growing up, they were the academic super-stars, popular, and more or less well behaved. Their symptoms were overlooked when they were children because they seemed to fare well without medication or therapy.

The first time I remember having a panic attack was in fourth grade. I didn’t call it that. I didn’t call it that until I was a junior in college. But when I was nine, I had the test the next day on the digestive system, and I didn’t feel prepared so I burst into tears, the big back-shaking kind, with liquid coming from everywhere, eyes, nose, mouth. I don’t remember what my mom said. I do remember that she came into my room later that night and took the diagrams of the stomach and intestines and the flashlight from under my blankets. I got an 103 on the test. No one worried, because when the tears dried I was an overachiever....

On the molecular level, Speed—the blanket name given to a group of drugs that produce the stimulant effect—and Adderall are the same drug. Both are Amphetamines—the title that is given collectively to an assortment of drugs with similar molecular structures including Meth, which can be made illegally in secret laboratories. Amphetamines, legal or illegal can be taken orally, or through injection, smoking, or snorting and create the same rush.

When I nervously asked a psychiatrist counseling center what the difference was between Speed and Adderall, he said, “nothing. Molecularly, they are the same. The difference is how you take them. Adderall is prescribed in small, controlled doses.” The illegal counterparts of the drug clearly are not.

It’s of little surprise then, that Adderall is easy to get on college campuses. Students, some joking some not, beg for it when they are faced with pulling an all-nighter. Other students use it as a party drug.

“I snort it sometimes when I'm going out for fun, because it hits you faster if you snort it,” an NYU student identified only as Mary told The Washington Square News.

When I told a friend via an instant message chat that I wasn’t sure if I was going to get a prescription for Adderall, he wrote “WHAT!?!??!...but like, it's speed.”

Which is exactly why I didn’t want to take it. Edward Hallowell, a physiatrist who has ADD himself, treats it and has written multiple books about the subject, listed “[t]endency towards addictive behavior,” as a symptom of adult ADD in his book Driven to Distraction. Later in the book, Hallowell, describing high stimulation ADD, a specific subset of Adult ADD, “he—and it is usually a he—may seek high stimulation through relatively safe avenues [such as] creating tight deadlines to work under.”

I don’t know if I have high-stimulation ADD. I don’t fit all of the descriptors and I am not a risk taker in the most widely accepted form it takes. I am afraid of roller coasters and skiing. But I am addicted to deadlines. Ask the person who sits next to me in the library. I hate the exhaustion that comes with writing on tight deadlines. But I love the rush that comes with them.

I have a tendency to addiction—my dependency of coffee indicates that much. So I am afraid of prescription medication.

"A Man Walks Down the Street, He Says, Why Am I Short Of Attention? Got A Short Little Span of Attention" - Music and ADD

A while back, the New York Times ran an article about the dangers of multi-tasking. I thought it was ridiculous at the time and I still think it is silly. It contains "news" such as "The findings, according to neuroscientists, psychologists and management professors, suggest that many people would be wise to curb their multitasking behavior when working in an office, studying or driving a car."

I can't imagine that even people without ADD actually think their attention is equally shared among things like talking on the phone and paying attention to the road. It didn't strike me as something scientists needed to study.

But I have been thinking a lot about this line in the article: "Listening to soothing background music while studying may improve concentration. But other distractions — most songs with lyrics, instant messaging, television shows — hamper performance."

I listen to music with lyrics while studying and writing papers. I have been trying to writing papers in a quiet library recently, and it has been a disaster. One of the things about ADD is that people with ADD are more likely to seek out distractions or get distracted by things that are available and interesting but is not the task at hand (O.K. that's essentially a working definition of ADD). For me, that manifests itself as a lot of time on the Internet. (Case and point this blog). But when I am listening to music with lyrics,--I try to choose songs whose lyrics I already know so I won't spend time trying to figure out the lyrics--I am less likely to get distracted by all out time wasters like Internet or random walks. I type more quickly and am more focused. It's choosing the lesser evil and I think it works.

Lyrics in the Title from Paul Simon's "You Can Call Me Al" click play below to hear the song (with a weird video).

Paul Simon - You Can Call Me Al
Uploaded by manon42

ADD Books: Part I: Finding The Symptoms That Make You Say "Aha!"

I didn't forget about the promised science posts. It turns out they are a lot more complicated than I thought. I will get to them when I understand more about the science of the medicines. But for now, I want to write about some of the more anecdotal things. I have been doing a lot of reading both online and in books. One book that I plowed through today (skimming the parts that seemed less relevant to me, but reading most of the first 100 pages) is Driven to Distraction by Edward M. Hallowell and John J. Ratey, both doctors with ADD. (They chose to use ADD instead of ADHD because it is more inclusive since hyperactivity is not assumed). It is an easy read full of anecdotes but not skimpy on the real science. There is some of the laughing at ADD that I find annoying (like questions such as "did you have trouble reaching the end of this questionnaire), and some repetitive language that I suppose is helpful for people who read the book in more than two sittings, but mostly it is very well done.

I've found reading about ADD frustrating because often I don't fit the symptoms, and I find myself questioning the diagnosis and saying "this is not me". I have always done well in school. I am good at evaluating myself, and I am not really impulsive, for example. But Hallowell (the book is mostly in his voice) describes enough different cases that I have found symptoms close enough to mine, even though he suggests that someone with ADD would meet 15 of his 20 symptoms where I barely meet 12 of them.

There was one patient he wrote about, Sarah (pages 94-101) an adult with ADD, whose symptoms made me understand more about me and about some of the people in my life. I am just going to block quote here:

"Oh," she answered, "that is about a cough drop someone left on the dashboard of our car. The other day I saw the cough drop and thought, I'll have to throw that away. When I arrived at my first stop, I forgot to take the cough drop to a trash can. When I got back into the car, I saw it and thought, I'll throw it away at the gas station. The gas station came and went and I hadn't thrown the cough drop away. Well, the whole day went like that, the cough drop still sitting on the dashboard. When I got home, I thought, I'll take it inside with me and throw it out. In the time it tool for me to open the car door, I forgot about the cough drop. It was there to greet me when I got in the car the next morning. Jeff [her husband] was with me. I looked at the cough drop and bust into tears. Jeff asked me why I was crying , and I told him it was because of the cough drop. He thought I was losing my mind. 'But you don't understand,' I said, my whole life is like that. I see something that I mean to do, and then I don't do it. It's not only trivial things like the cough drop; it's big things too.' That's why I cried. "
It was such a classic ADD story that I've come to call it the cough-drop sign (Page 95).

This anecdote reminded me of myself in a lot of ways. Though I can't think of any specific incidents, it was familiar. But more importantly, it reminded me of someone I know, who is in her 50's (like Sarah in the story) and on occasion worries that she is developing Alzheimer's disease--like after she read a New York Times Magazine Lives column about Alzheimer's disease, or after she watched an episode of the West Wing where the White House Press Secretary C.J. Cregg spends time with her father who has Alzheimer's. But the symptoms she most worried about were most similar to the cough-drop symptom. Maybe it's not as scary as Alzheimer's. I bet it's ADD.

Sarah provided Hallowell with a whole list of things she thought were relevant that bothered her. Some of them did not apply to me at all. Other ones made my mouth drop in recognition. Those are below. I list them here, in a blog that is supposed to be more informational than personal, because I would never have associated them with ADD, but Hallowell did--calling Sarah's list something that "could serve as a pamphlet on adult ADD" (page 98)--and so I think others would be equally surprised at the links between the symptoms and between the symptoms and ADD.

I am going to list all the ones in Sarah's list that apply to me. Some are more surprising than others. I don't want to give the impression that I am a totally atypical person with ADD I have put stars and notes next to the ones I found jaw-dropping.

CAUTIONARY NOTE: This list makes me seem like a total space cadet. Most, if not all of these things DO NOT CONTROL MY LIFE. I have figured out how to work around them or to use them to my advantage. I am very successful and trustworthy. Also, I am NOT BLAMING ADD. Some of these are things that I am going to work out, ADD or not. It's just cool to see that they might be connected to one another. (There's my fear about someone figuring out who is writing this and using it against me).

With that out of the way, the list:

• "Daydreamed a lot in class as a child."
• "Have lots of ideas but have a hard time structuring things so they actually happen."
• "Desk cluttered."
• "Forgetful."
• "Difficult to walk in a straight line--tend to veer into things or people." *** (My friends used to make fun of me for this. I have one--very close--friend who used to see if he could edge me to the curb to see if I would walk into a telephone pole. It almost always worked. I had NO IDEA this could be ADD related).
  
• "Unless I am involved, usually get very sleepy during lectures.
• "Handwriting: sometimes I wrote things I don't mean to; skip letters or form them wrong." *(I have used this to my advantage in creative writing to come up with unique turns of phrase).
• "Lose what's in my head very easily."
• "Organize my life around projects"
• "Problems with lateness. Even when there is plenty of time, I fill it up and then cut things too close or lose track of time. I don't have a sense of passing time." * (I sometimes have a very acute sense of passing time. But sometimes I have no sense at all. I thought that I just loved working on tight deadlines, but this gave me a different perspective).
  
• "There is something inside that needs to change."* (This was something I just noticed this year as I started talking about ADD).
  
• "Doors and drawers--never close them after myself, then come back and see them and close them."* (I always got yelled at for this. It's cool to see how much of this might be related.
  
• "Get overwhelmed by a large confused mess."
• General problems with distractibility and disorganization."
  

That's a ton of descriptors that I thought matched my life. It was the first time I have actually felt the relief that everyone keeps saying comes with a diagnosis. It was the first time that I actually seriously considered taking meds. I will post soon on meds and fears about them, but I want to do that when I am more informed.

What Does It Mean To Be Tested?

I was frustrated by the lack of Web sites out there that actually told you what the test for ADHD is. In my experience, the test was simply an extend psychiatric evaluation (a lot of questions that you answer) and then we looked at the list below. (Note that I was not being tested for any learning disabilities, where a test is probably longer and more varied in type). The list is from The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. In order to be diagnosed with ADHD, one must show at least six symptoms from a single category (I think. It may be that you need six from each subtype). Symptoms must have been displayed in at least two settings (school, home, work, etc.) and have been present before the age of 7.

I have only the first subtype--inattention. That's what most people call ADD, but it's really just a subtype of ADHD. The other choice is combined inattentive and hyperactive.

This is not meant to be a self-diagnosis reference. When I described these symptoms to my friends, a lot of them said that the 'symptoms' were things they saw in themselves and in others as parts of personalities.

Generally, an ADHD diagnosis means that the presence of these symptoms has been detrimental to everyday life. However, many adults who have lived with it have adapted much of the effects of ADHD into their normal life. For me, that means laughing off the disorganization, making friends who are sharp-tongued and fast paced, attraction to a varied work environment, and listening to music while writing papers. For me, that also means that I have not decided whether or not I am going to take medication.

SYMPTOMS OF INATTENTION
a. often ignores details; makes careless mistakes
b. often has trouble sustaining attention in work or play
c. often does not seem to listen when directly addressed
d. often does not follow through on instructions; fails to finish
e. often has difficulty organizing tasks and activities
f. often avoids activities that require a sustained mental effort
g. often loses things he needs
h. often gets distracted by extraneous noise
i. is often forgetful in daily activities

SYMPTOMS OF HYPERACTIVITY-IMPULSIVITY
a. often fidgets or squirms
b. often has to get up from seat
c. often runs or climbs when he shouldn't
(in adults, feelings of physical restlessness)
d. often has difficulty with quiet leisure activities
e. often "on the go", as if driven by a motor
f. often talks excessively
g. often blurts out answers before questions have been completed
h. often has difficulty waiting his turn
i. often interrupts or intrudes on others