A New Try

I have four alarm clocks in my room not counting my cell phone. I have a clip with an outdated to-do list. I have a coffee maker. I have three lamps. I have a desk and two other places to sit that are not my bed. I am taking ADD meds (yes, I decided to take this piece of information public, more on that to come). I still do not feel like I am Getting Things Done.

So starting today, I am going to try a new strategy. Forget about the technology. I am going old school.

Today I am buying binders and a white board or two. I am making lists that are easily changeable, and I think the one technology thing I am going to do is set an alarm (maybe on my computer) to go off at bed time. I am going to try to forget about the panic that these goals make me feel and focus on this problem like a scientific experiment. I am going to try to post on this here, costs and all.

It IS Personal

I long avoided writing anything personal here, the thought being that this was going to offer the facts, and other places could offer feelings.

The problem is, it doesn't work like that. At the end of the day ADHD is a whole lot more than some misfiring synapses in the brain and questions about which medicines work and how.

It is almost entirely about how it effects ones life; if it had no effect, if it were only about the synapses, than it wouldn't matter at all if anyone had ADD. It would be a quirk like red hair or left-handedness.

But it's not. I recently read an interesting kids' book The Lightning Thief. Broadly, it and the other books in the series answer the question "what if there were children of the Greek gods among us mere mortals today." The answer, in it's unfairly abbreviated form, is those children would all be dyslexic (hard wired to read Greek not English) and have ADHD (hard wired for battle not modern-attention spans).

The thing I liked about it, is it didn't glorify ADHD. When the kids are in the special camp for "half bloods" (half god, half mortal) they are in their element, but they are nowhere close to godliness in the world everyone else exists in. They have real problems in school and in making and keeping friends. They suffer realistically with severe cases of dyslexia and ADHD.

It is a great read for middle school students because it is an intersection between literature and mythology, and--perhaps more importantly-- it creates a platform for thinking about what kids who are different have to offer (that probably takes a teacher's prompting, since kids are generally not threatened by titans in their day to day lives).

But for me, it also gave another message, one that I've been avoiding: this is something I have. It's the way I am. For better or for worse. Period.

So when my mom asked why a three page essay was taking me so long to write, I said "that's the way I'm wired" and moved on to talking about the importance of research and the idea that "the dignity of movement of an iceberg is due to only one-eighth of it being above water."

But being able to say "that's the way I'm wired" is the result of months and thousands of dollars in therapy. Which is to say that therapy is expensive and, I think for people diagnosed with AD(H)D in their adulthood, often necessary.

I still get massively frustrated with how long it takes me to get things done and the anxiety that the lost time and the frustration produces. But even as I am annoyed at myself, being able to say "that's the way I'm wired" without it feeling like a lame excuse, rather an explanation of how I will inevitably approach the world and the tools I will need to find and develop, is something that is important enough for me to share with others.

Important for me to post on this blog. So maybe others in similar positions will mull it over themselves.

News For Thought: Broader Mental Health, Learning To Swim

Internet troubles have slowed a bunch of pending posts, but in the meantime, I want to post an incredible project the Columbia Daily Spectator has been printing for a month or so: Mind Matters.

It's about mental illness and mental health in general, not just about ADD, but certainly worth the read.

And, for an incredible, personal account, read the editor's column, the first paragraphs (and last) of which are published below:

To the tenured, highly esteemed anthropology professor who failed me last spring:
“Why are you even here?”

This was the first thing you said to me a year ago when I sat down in your office before you explained that I would not be passing your class.

It was understandable. I barely attended any lectures or discussion sections, let alone turned in any of the assignments. I earned what Columbia students have to work extremely hard to receive: an F.

I left Schermerhorn, bawling as I walked back to Watt, where I hid for the entirety of my junior year. I thought about Richard Ng, a student who committed suicide by jumping into the East River two years prior. I didn’t know how to swim. It could work!

I ended the semester with an impressive 1.8 GPA. I felt mostly dead. But looking back, I realize I was living, and that was the point.

“Why are you even here?”

I didn’t come to Columbia to be depressed, mind you. I came here to take my high school valediction and press onward, to become editor-in-chief of this paper, to meet the man of my dreams. None of these things happened.

After a tremendous freshman year, things spiraled. I teetered on the edge of my 20th floor window in EC and looked down.

Over the next year, I would accumulate a number of diagnoses: major depression, recurrent, without full inter-episode recovery (DSM-IV 296.32), and borderline personality disorder (DSM-IV 301.83). One psychiatrist told me I actually had bipolar disorder. My mom told me I wasn’t practicing Islam enough. A professor actually told me I was a liar. My friend told me I was just being 20.

You could say this period constituted a Profound Experience, the one often criticized in other senior columns. I know I’m a cliché, and I laugh about it often. (See headline.) But, it is my experience, and it is all that I have....

I am painfully aware that I might have another depressive episode in the future.

But this time, I can handle it.

I wish you could see me now, professor. I got a 4.0 last semester. I live on the 20th floor of EC again, two doors down from a previous site of trauma. I am learning how to swim.

The Devil You Know

Part 2 in a series on medicine and the thought processes that go into deciding to take it. Read part one here.

Before I start this post I need to stress: I have no training scientific or medical and I cannot stress enough how important it is to consult with a doctor before making any decisions about medicine or treatment. End disclaimer.

In the year this blog lay dormant, I thought a lot about medicine for mental illness. I have seen my friends-- and, frankly, myself--struggle with a bevvy of diagnosed and undiagnosed problems and then struggle with the question of whether or not to take medicine.

What is it about taking medicine for mental illness that makes people balk? We take medicine for all sorts of things. For allergies, for colds, for muscle aches, for cramps, there's a pill for every ailment and we take them and praise modern medicine.

And then, we face mental illness. For many mental illnesses or disorders there are even physical symptoms. I don't think there are any direct physical manifestations of ADD, but the possibility of anxiety that comes with unchecked ADD certainly has physical effects, as does depression, which also can stem from unchecked ADD.

But its not the physical symptoms--of any mental illness--or not only the physical symptoms. Emotionally and mentally, medicine can be life changing and, in some cases, life saving.

Why the fear? Why the worry about taking medicine that can change a chemical makeup on the brain? That can address the biological basis of something as confusing and often as intangible as mental illness and disorders?

I don't have all the answers. I wouldn't even presume to have a single fully formed answer, and I can't speak for other people's fears; this is a question that plagues even some of the most accomplished psychiatrists and psychologists. But I've been thinking about it a lot and I have a theory.

I think that this idea works best when applied to adult mental disorders, which is the focus of this blog. I think it is particularly applicable to ADD, because unlike some other disorders that are treatable with medicine, ADD is something that doesn't just show up. You might get diagnosed later in life, but once you're diagnosed, you know that you've had it for a while.

Not to resort to cliches, but I think that the question of treating adult ADD is a question of the devil you know versus the devil you don't. Someone who gets an ADD diagnosis in adulthood had already found some coping mechanisms. Even though the coping mechanisms likely will have failed enough to start thinking about treatment in the first place, ADD is the way that you have lived . However effective or ineffective those coping mechanisms were the whole package of struggle and coping become part of your personality; you know what it feels like, you know what it looks like.

Medicine, however, is not known. Additionally, it's the failures of medicine that get more attention that success. Breakthrough technology gets coverage, but the day to day stories of people taking pills and feeling better are not news, are not talked about, and are not fretted about. A brief look at just some of the articles that have caught my attention, indicate how scary the Internet can be when you are looking for guidance.

In recent weeks the Supreme Court ruled that patients could directly sue drug companies, which then lead up to several other cases, where people who committed suicide while taking different antidepressants. It's in the news, and its frightening.

And then, there was a mystery diagnosis that the New York Times Magazine printed which featured some scary stuff about Concerta, one of the ADD meds. (That article, I think deserves its own, nuanced blog post, because Concerta is safe and was used in an extremely unusual situation that became unsafe). And there is news of over-diagnosis and over-medication. And then, this article about Paxil resurfaced on Slate. I suspect that it resurfaced because of the renewed interest in the legal ramifications of misusing, or mis-prescribing drugs, and because of the settlement of a case regarding poorly-made pills.

So there's the news, and the fear that the medicine will change your personality (whether that's the coping mechanisms or something larger), and the fact that at the end of the day, the only way you can tell if medicine is working out is by trying it and seeing how you feel. That trial and error process can be both scary and frustrating. And then there's the stigma, which to be perfectly honest should be lifted, but its not. It's still going strong, which is why this blog was anonymous.

So then you choose.

The devil you know: ADD and everything that comes with it: all the crap that comes with it, all the personality quirks that might be part of it, and all the coping mechanisms that you've sorted out over the years.

And then the devil you don't: medicine, all its uncertainty, and all the frightening stories that float around.

It's hard to get past that fog and see the positives, the possible assets among all the uncertainties.

That's one theory at least.

Adult Manifested ADD

Once I committed to coming back to this, it was hard to actually do so. First, I started this blog while on Spring break in college. And, second even after that, I had more time -- and more personal need -- to write this blog.

But, recently, now that I'm no longer in college and am now in the real world -- whatever that means--I've been thinking a lot about ADD again. Particularly about the warped, incorrect term "adult onset ADD."

The DSM standards mandate that symptoms manifest themselves before the age of seven. That much is clear. But then, there is the fact that this is a blog about adult ADD. As I understand it, there are two types of adult ADD. There are the people who had child ADD which turned into adolescent ADD, which turned into teen ADD, which turned into adult ADD.

And then, there are the people, who were diagnosed with ADD as adults.

In my case, it was the latter, though it came as a surprise to no one, including -- well, hypothetically--my first grade teacher who administered the hearing and listening test I failed.

But I would suggest the term "adult manifested ADD." A psychiatrist I recently spoke to said that for many people, ADD surfaces at different times in different people's lives: for some it's high school, for some it's college, for some it's medical school, and for some it's a first job, or a marriage, or what have you.

Different changes trigger different types of symptoms, different manifestations, and that's when the diagnoses come in, offering help in the wake of changes in a person's life that can be big enough, or different enough to allow the ADD to manifest itself.

I'm Coming Back

After more than a year's hiatus, I am back. This year has been difficult and remarkable, and I want to share parts of that, because I wish I had had someone else whose experiences reflected mine. The two postcards here are from Post Secret. I don't know who wrote them, but they will be my jumping off point, my raison d'etre for coming back to this blog.

Every once and a while, I see a secret on the Web site that reminds me of myself, but these two so closely encapsulated my most recent decision to return to grappling with ADD, that I gasped. I am sharing them here and will refer back to them in the near future.

I hope that I can develop this Web site into a real resource for others. Again, please e-mail me at addblog@gmail.com or leave a comment if there is anything you would like to see.

With a year break, I will have to do some promotion to get readers, but I am also going to change the focus of this blog a bit.

Lots more to come.

Stereotypes, Ignorance, and Britney Spears

I have not posted in ages, and I promise to write a substantive post soon. But for now, I just wanted to comment on something that I found ridiculous, offensive, and factually incorrect.

Last week's US Weekly, which granted is not the authoritative source on anything other than photographs of and gossip about celebrities, wrote (emphasis mine):

Days after a judge ruled that Britney Spears could only spend three days a week with her children, she reacted by leaving her two kids in a parked car with a court-appointed monitor (whose job description does not include babysitting) as she shopped for $18,200 worth of chandeliers at the Crystal Place design shop near L.A. November 4.

Why does Spears, 25 — even after having physical custody of her kids taken away — keep exhibiting such questionable parenting skills?

Sources say the troubled pop star does not seem to grasp the gravity of her custody case, and they blame her bizarre public behavior (swapping clothes with a stranger, among her recent moves) on psychological issues, not drugs.

“It’s not substance abuse — it’s mental!” a confidante tells Us."Pals suspect adult-onset ADD or depression, with one friend saying, “Postpartum has always been a problem” after giving birth to Sean Preston, 2, and Jayden James, 1."

This is problematic for a number of reasons.

First, it might be true that Spears is dealing with mental illness, but it is unlikely that all of her bad judgment, or even most of it can be attributed to mental illness. The article implies that people with mental illness, people with ADD or depression would be unable to take care of children, or that an imbalance of serotonin or norepinephirine would cause someone to think it was O.K. to trade Halloween costumes with the bartender. I am not a doctor -- and it should be noted that Spears' friends and US Weekly sources are not doctors either--but I am pretty sure that that's pretty unlikely.

Secondly, and this is what caught my eye in the first place, there isn't really such a thing as "adult-onset ADD".

According to the DSM It is essential that "some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years. As Doctors Glenn Brynes Carol Watkins, of Northern County Psychiatric Associates in Baltimore wrote, "By definition, AD/HD is a condition that has its onset in childhood."

It's great that Spears' friends -- or so called friends since they are dishing to magazines instead of getting her help--are concerned, but US Weekly perpetuates all sorts of falsehoods and stereotypes by printing these guesses. All that would have been needed to fix it was one line from a doctor explaining what was and what was not possible. Maybe this week's cover story on Spears' childhood will reveal a long-time struggle with ADD. Maybe. I am not holding my breath.

I am all for celebrities with ADD or any other disorder talking about it to raise awareness and to educate people. But spreading ignorance and perpetuating stereotypes? It doesn't make dealing and living with ADD any easier for those who have it. Even US Weekly should do better than that. Or for a magazine as widely read as US, maybe I should say especially US Weekly.