Now I Begin,
Now I Begin,
My brain is a whirling, twirling, swirling tornado. As I move through my day, everything around me is pulled in and gets caught up in a continuous rotation as it is dissected, analyzed, and discarded in the form of misplaced keys, wayward cell phones, unfinished projects, forgotten names, faces, and moodiness. How things smell, look, feel, think, places, ideas, projects, stories, names, numbers, notes; round and round my mind goes landing on seemingly unrelated topics before it’s off to the next thing. Round and round it goes, never quiet, never silent, never still, until it slowly loses energy and the rotation ebbs. The tornado turns into a storm, then a heavy rain, sprinkling, and finally sleep. My tornado of a mind is no longer a tornado and I am passed out in deep sleep-dreaming, worn out from mental fatigue.
Tuesday June 14, 2016 2:30 pm Family Practice Naval Health Clinic
“Christina, have you ever been diagnosed with ADD/ADHD as a child?”
“Do you know what ADD/ADHD is?”
“Isn’t that what they diagnose little boys with in first grade when they can not sit and be still?”
“No, that it is what people think they diagnose little boys with in first grade who can not sit and be still.”
It is one of those days where I try to kill two birds with one stone and schedule an allergy shot along with a medication follow up on the same day. I am going to be at the clinic, might as well get it all done. Up since 5 am, and at the doctor’s office since 12:30, it’s well past time for a snack and nap. Although I am sleepy, my doc can see I have visibly improved since my last visit and he is pleased. My moodiness and anxiety seem to be somewhat under control. I express the concern that I am unable to focus on my work for more than 2 hours at a time. Eyebrows come together, and Dr B leans forward in that conspiratorial way he does as if he is about to let me in on a secret. I know it is not a secret. This is the look he gets when he is trying to determine if a symptom I am exhibiting is a result of something physical or something mental. He is concentrating and a light bulb has just gone off in his head. So that’s what concentration looks like. Oh great, here come the questions.
The Questions, the stuff a doctor asks you to help with a diagnosis. I hate the questions, because the answers should be straightforward. On a scale of 1-10 how much does this hurt? How often do you feel this way, or that way, or need to do whatever. Problem is, nothing is straightforward in my mind. I never seem to be able to answer in a concrete way. Often I have to ask a doctor to repeat the question because for some reason although I have heard what is asked, I am unable to comprehend it. My answers vary with the standards being; I don’t know. Sometimes. What do you mean? Huh?
“Christina, can you do something you do not like for 2-4 hours?”
Eyes wide with horror, “No way! Can anyone do something they do not like for 4 hours?!!!!?”
“Can you do something you like for 2-4 hours?”
“Yes, but I have to take breaks. A lot of them. Except for reading. I can read forever, but I have to like what I’m reading “
Attention-Deficit/Hyperactivity Disorder (ADHD) is a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. It is and has always been a controversial diagnosis particularly when discussing treatment. Add in the term adult and boom, a whole lot more controversy with a heaping of judgement is perched on top like a cherry on a sundae. It’s not real. They’re just disorganized, lazy, unambitious, undisciplined, selfish, rude, moody..crazy.
I am none of those things, except for maybe disorganized. However, I have said all those things about myself. All of them, in my head and even jokingly in conversations. I was not joking. I saw myself as flawed, imperfect, but not in a normal way..abnormally incapable. Harsh, right?
Diagnosis for ADHD used to be with an onset of 7 years old. That has since been updated to 12 years of age. Undiagnosed adults are given the diagnosis through a series of questions about their childhood behavior. Boys are more likely to receive a diagnosis than girls. A 2004 survey found that 84% of teachers believed that ADHD was more prevalent in boys than girls. Despite this disparity, studies on adult ADHD have found that there is an equal balance between men and women. Often associated with hyperactivity; ADHD operates on a spectrum with women and girls more often being diagnosed with inattentive type. When not treated as a child, symptoms of ADHD can disappear by the time of adulthood or individuals have developed coping mechanisms in the form of personal behavior modification. Interestingly adult women with ADHD tend to have a lower self perception than men. As women, we mentally beat ourselves up.
ADHD in adults does not look the same as in children. Many adults do not realize their issues are ADHD related until they seek treatment for their child and find they can relate. Unpaid bills, unmailed Christmas cards, forgotten thank you notes, RSVP violators, chronically late, fast talkers, interrupters, disorganization, and memory problems are all characteristics of an adult with ADHD. The hyperactivity element in children is usually the bugle heralding the disorder; however by adulthood the hyperactivity is often internal. Instead of focusing on one thing, the ADHD brain zeroes in on four to five things at one time. Depending on where one falls on the spectrum, it can be difficult to “adult” when you are an adult with ADHD.
Here I am in a Doctor’s office and being diagnosed with a condition that I had previously associated with little boys with ants in their pants. Here I am a 38 year old woman, frustrated with herself. Disappointed in my abilities to keep my house organized, my desk organized, my life organized as well as my seemingly inability to complete the most mundane things had built up over the years. I am overflowing with self-loathing.
Why in the world do I interrupt and argue? Why am I so contrary? Why do I get overemotional? Why can I not remember names, and people, tasks? Am I going crazy? Am I developing dementia? Why do I wait until the last minute? Why do my best ideas come at the last minute? Why do I have a drawer full of unsent birthday, Christmas, Father’s Day Cards, etc.? Why? Why? Why? What the hell is wrong with my brain?!?!?!
People often associate the inability to focus with ADHD and it is in fact a primary indicator. The truth is is a lot more complicated. The ADHD brain is unable to focus is not an adequate representation. The ADHD brain wants to choose what to focus or simply wants to focus on everything at the same time. Procrastination is defined as the action of delaying or postponing something. ADHDers procrastinate chronically. Whereas the standard brain does not differentiate the importance of doing something based upon how enjoyable or interesting it is, the ADHD brain does. Once engaged the ADHD brain goes to town and does not like to be interrupted. It is hyperfocused. In my experience, once I start something I need to get it done! I have to get it done, and being interrupted particularly by touch is not only irritating but physically uncomfortable.
Lemons Home Washing Dishes
Internally thinking, “I’ve got to get these dishes into the dishwasher to make room on the counter so that I can cook dinner, so that dinner can be ready by in time for me to have time to walk the dog, give D a bath…I need a new sponge this one is wearing out gross I don’t like way it feels. Well just get gloves! Why have I not gotten gloves yet? My eczema would be so much better if I wore gloves. Should I go to the doctor about it? I am tired of going to the doctor. When is my next follow up? When is my next blog post? I need new dishes. I need new forks. Blog post idea, disappearing forks, children’s story idea- disappearing forks. They have sponges at the dollar store and they are cheaper than sponges at the grocery store. Is the quality the same?
Enter Love of my Life seeking affection and attention, wraps arms around me tenderly planting kisses along my neck.
Crash! The tornado of thoughts intensely whirling around my brain come careening down around my mind like shards from a glass wall. As in the case of pieces of broken glass, some of those thoughts are lost to me, hidden until they are randomly stepped on. A new tornado is taking the place of the old one and this one is destructive.
Internally, “That feels nice, crap my time line is going to be thrown off, I need to finish this, I need to finish this now? Why does he wait until I am doing something to be affectionate? Don’t say anything, you’ll hurt his feelings, but I need to finish this. I need to finish this now, because….”
Rising sensations deep from within my chest radiates throughout my entire body, particularly at my neck where the gentle touch of those sweet kisses that felt so good a second ago is replaced by a physical displeasure and the tornado finds a new target…my husband. Cue argument and hurt feelings.
Why am I like this? Why do I do this?
Here I am at 38 and this wonderful doctor is looking me in the eyes with compassion, understanding, and determination,“You are not lazy. You are not crazy. We can do something about this.”
Doing something about 38 years of behavior is not an easy task. First steps are medication and therapy. Therapy is a rose with thorns; beautiful to look at but painful to touch. It is also like being an onion with each layer of skin slowly peeled off until you are naked and crying. Not easy, but rewarding. Placing myself under a microscope and magnifying every aspect of how I go about my day is agonizing and time consuming. My husband likes to say nothing worth doing is ever easy. I agree.
One of the difficult things about adult ADHD is it rarely travels alone. The mind become a party space and the ADHD starts inviting its friends over. You never know who is going to show up and some of the guests can be downright rude. Anxiety, depression, obsessive compulsive disorder love the ADHD mind. Not just bad guys come along for the fun, a couple of the super cool kids happen to stop by as well. Empathy, sensitivity, creativity, imaginative, and intelligence are hanging out there too. Sometimes the other guys can be a little louder, and the good ones have a hard time being heard.
Camp Lejune Clinic, 2000 and Something
“Good Afternoon, Mrs Lemons. How are you today?” (why do they as that question? Obviously I am not well or I would not be here.)
Smilingly weakly, I answer, “I’m okay.”
“What brings you in today?”
“Something is wrong. I am not feeling like myself. I have been feeling edgy and easily irritated. I snap at my children. I cry for no reason at all. Everything makes me cry…it hurts. I just want to sleep, I keepforgetting stuff, and I zone out even while driving.”
“When did you start noticing this?”
“Well, I guess I’ve always been a little dark. After my first pregnancy I got a little more moody. I had some postpartum after my second birth, but after a while I was okay. Since my husband left on deployment, It has gotten worse. A lot worse.”
“I’m sorry to hear that. How many times has your husband deployed?”
“This is his sixth.”
“You likely have Major Depressive Disorder, what used to be called depression. We see this a lot in military spouses, especially those who have been through multiple deployments. Also, sometimes after having children the chemicals in the brain just go a little haywire and need some help righting themselves again.”
Depression and ADHD
In 2014, an estimated 15.7 million adults aged 18 or older in the United States had at least one major depressive episode in the past year. This number represents 6.7% of all U.S. adults. It is estimated that depression affects 1 in 10 Americans at some point with over 80% of the people with symptoms of clinical depression not receiving any treatment. Women, being the sensitive creatures we are, are twice as likely to have symptoms of depression as men of the same age with 1 in 10 women experiencing symptoms of depression after having a baby.
The depression ebbed and flowed as time went by. I coped. Most adults with undiagnosed ADHD naturally develop different coping mechanisms and accommodations to address some of their ADHD symptoms. I am the master at coping mechanisms. I do not just pick out my clothes in the morning, I select the appropriate personality mask along with my outfit. Each mask mentally organized with my idea of how I am “expected” to behave or feel and even think. Walking into a Doctor’s office and admitting I needed help was a huge step for me. That day I made a decision not to just seek help but to step out in front of my depression and mandate, “You will not lead me. You will not define me. I lead me. I define me!” and so began my journey of self discovery.
Depression is no joke and when I started to take medication it was like putting on glasses for the first time. So this is what the world looks like. This is what my world looks like. Suddenly everything had a place and needed to be put in its place. Kitchen shelves got labels. The tupperware cabinet suddenly became navigable. No more sitting on the edge of the bed, body wracked with grief crying uncontrollably over what I didn’t even know. Although my symptoms had gotten better and my quality of life had in fact improved there was still something missing. I could not figure out what it was. It took an additional four years and an amazingly compassionate doctor. Dr B took the time to listen to me. He was not dismissive or judgemental. He did not say, “Take two of these and call me in three weeks.” Dr B took his time with me. He probed, pulled, joked, and annoyed the crap out me. The most important thing he did was to listen. His ability to listen to things I said as well as the things I did not say allowed him to put into place the missing pieces of my emotional puzzle.
At an estimation of 2.7 times more prevalent among adults with ADHD then the general population, depression can wreak some serious havoc in the ADHD mind. I remember telling my doctor, I don’t know why I am sad! I am sad for the world! This type of depression can be tied to a condition called hypersensitivity. The hypersensitive individual, often labeled “drama queens”, can experience a high level of sensitivity to sound, touch, smell, emotional stimuli and even sight. They are more likely to suffer from asthma, eczema and allergies. I have had eczema since I was a child and have recently started allergy shots!
My ADHD diagnosis has been a revelation! I celebrate it. I am not embarrassed. I am excited, elated, energetic. I can address this! This in itself is a typical example of how my ADHD brain works. It loves complex problems. Problem solving is my forte. I can come up with a plan; now following through is another story. I need some additional tools for my tool belt to solve a couple, okay maybe more than a couple, of everyday issues. Yes, a lot of it is common sense. With my tendency to not focus or to even hyperfocus on the big picture, it is easy to miss the common sense solutions. The details elude me. I swear my brain moves at 100 mph around a traffic circle, taking all of the exits at the exact same time!
Understanding my diagnosis and how ADHD has shaped my personality and experiences with others has taken me to a whole other level of self awareness. I am not making excuses. I am understanding who I am and how I think, and as a result how I can change behaviors in a way that will be positive and enduring. I have accepted that I am in fact imperfect. Guess what, so is everyone else. ( If you think you are perfect you are deluding yourself and I recommend you go get help.) I am not a bad person. I am a good person. I am not lazy, stupid, overly sensitive or selfish. I am not broken. In my opinion saying I have a disorder is inaccurate. I simply think and feel things in a unique way. I am imperfect. That is okay. I can be disorganized. I can be forgetful. I can be a little late. I can get overexcited during discussions. I can lose my way during discussions. I can be like…squirrel…now what are we talking about? I can be unfocused. I am also loyal, loving, kindhearted, a strong communicator, creative, intelligent, optimistic as well as realistic, a great problem solver, dependable, and a seriously hard worker!
I am not perfect, I am perfectly imperfect!
Collingwood J. ADHD and Gender. Retrieved from http://psychcentral.com/lib/adhd-and-gender/
Major Depression Among Adults. Retrieved from http://www.nimh.nih.gov/health/statistics/prevalence/major-depression-among-adults.shtml
Depression Facts & Statistics 2012 Infographic. 2012. Retrieved from http://www.healthline.com/health/depression/statistics-infographic
Sherman, C., Ph.D. Is it Depression or ADHD. Retrieved from http://www.additudemag.com/adhd/article/748.html
Kessler, Zoe. Hypersensitivity is not Imagined. Retrieved from http://www.additudemag.com/adhd/article/8945.html
For additional Info and Support with ADHD click: ADDITUDE