Mungo's Adult ADHD Blog: Attention Deficit Hyperactivity Disorder

Right now, at this very moment, the world is okay.

2013-10-27T01:12:00.000-04:00

I've just been reading a lovely article. The writer was saying how they are quick to believe "I'm not good enough", or worthy, or that "I'll just never be enough". And it came to me that all of these very thoughts and feelings are transactional - that the words must be modified in context of, and because of 'the other'. Modified to: "I'm not good enough 'for X'", "and "I'm not worthy 'to be with Y', or that "I'll just never be enough 'to Z'."

That this is so, somehow strengthens my conviction that we just can't know what we need or want all that well - or if ever, very rarely. And I'm damned sure we can't know what the other needs or wants either.

Because - who knows? Maybe this 'other' just so happens to need or want me. Need and want me for reasons they'll never understand or be able to articulate. Ever.

And then it follows that it doesn't matter if I'm this way or that way. Whether the other person who could be in my life is this way or that way. Because to the other's needs or desires - well, I'm just what the doctor ordered.

Simple words, but they mean so much to me. Getting to know what I want or need has been so hard. That it is easy, is a lie our culture and our media perpetuates. And we lap it up. "Just figure out what you want. Find out what you need. And go for it. Fulfill your desires, fulfill your needs (and buy our products)".

And don't be fooled - I wrote "...has been so hard" just now. Don't think for a moment that I've reached an understanding of these fundamentals. Nope. A felt-sense, maybe. But only softly, softly - in the quietest of moments. And the deeper I go, the less concrete the answers become. The message that echoes for me, as I think about crucial moments of connecting or relating with others, is patchy at best. The signal and the words are garbled, and all that emerges, all that's heard is 'I want' or 'If only' or 'I want to them to hear me - to know me - to just accept me'.

'Me'. So simple, so fundamental.

And then I thought about this primal pulse, this drumbeat: "I want to be needed" and "I need to be wanted", softly softly, gaining and losing in volume as life washes by. Put two people together and perhaps there will be moments of harmonics. I mean, there ought to be, or so the odds go. Moments of sympathetic vibration - when my 'want to be needed', and my 'need to be wanted' begins to hum in synchrony with their 'want to be needed', their 'need to be wanted'.

And so when do we know when we love someone? When do we know when we matter to them, that they love us?

Know? That's a hard one. Maybe I know when my heart is quiet. Maybe it's when the waves aren't crashing over us. Maybe at those times when we're both lost in thought, or simply becalmed.

I think it's when I feel, and can hear myself somehow saying that "right now, at this very moment, at this very place, with this person - things are okay". But it's more than that. It has to be more than that. It can't be a few isolated moments. Relationships don't exist or develop in a few isolated moments. Relationships are built over a bedrock formed of a primordial time - older than we can ever know. They span our whole lives, even if we've only known one another for a month.

I remember this feeling - the isolated case of when everything was okay. I was with someone, and I felt that it was a moment without past or future - rooted there and then. I felt acutely that then and there, the world was okay. I knew that after that moment, things wouldn't be or feel okay but that this was acceptable because that's just how life goes. But that the feeling could return, given the right opportunity. Imagine being with someone where you experience this feeling over and over.

Maybe that's love. Nothing more, and nothing less. A sounding, a tattoo, a drumbeat - and when we listen carefully for a while, we both hear "right now, at this very moment, the world is okay".

ADHD and Diabetes - Horse Puckey!

2013-08-24T22:31:00.001-04:00

Okay. I've had it. Time for a rant.

I have HAD IT with these 'scientist' mumbo-jumbo medical establishment fakers. HAD IT! I'M FED UP! A bunch of liars, reclining in their Big Pharma funded laboratories.

Listen: I don't believe in that thing they call diabetes. And nor should you. It's fake. Just a bunch of lazy-ass attention-seekers who don't try hard enough to appropriately regulate their blood glucose levels with the hormone insulin. Regulate it, you losers! Simply buckle down, spend a little energy getting your pancreas creating insulin a teensy-weensy more responsibly, stop pigging out on junk food with high carbohydrate levels and quit bitching so much.

Honestly. Like we don't all have the same problems... We all suffer from low blood sugar at times. Right? Does that mean we all have diabetes? NOOO! What makes them so special? "OH I'M SO SPECIAL WAH WAH WAH."

Know this - diabetes is a made-up disorder, perpetuated by Big Pharma, and the totalitarian drug-pushing medical establishment who ignore the wisdom of our elders - exercise, morals, strength of pancreas and character. Insulin enslaves our youth, and alters their personalities so that their brain has appropriately regulated levels of glucose and so that their organs and CNS are not adversely affected, causing everything from wound-healing problems to amputation, organ failure, and death.

But big deal. As if we all don't have those problems. Everyone feels a little tired. Who hasn't collapsed in a coma after a hard day of work? Again, all I hear is "WAH WAH WAH I'M A WITTLE TINY BABY AND MY PANCREAS CAN'T PRODUCE ENOUGH OF MY OWN INSULIN WAH WAH GIMME A COOKIE".

This sort of preferential treatment, and pandering to special interest groups gets me so hot under the collar. I could go on, but spread this message: diabetes is fake. Don't let some 'scientist' scam-artists rob our children and adults of ill-health and poor functioning by pushing drugs (edit: I meant 'rob our children and adults of *good-health and normal functioning*... ').

Here is a little known fact, based on my EXTENSIVE research of these evil drug companies. Did you know that some insulin is OBTAINED FROM PIGS? Pigs - who sit around in mud and who many religions forbid us from eating. Think about it. Is pig insulin EVER mentioned in any holy text, or ancient document? No? Well, the ancients knew something that many people don't know today: PIG INSULIN IS BAD. Plus, have you ever wondered why the big media are trying to expose our children to tv shows showing pigs? Programs like Olivia (about a friendly pig), or Sesame Street (which tries to make it out that pigs are fun, and are okay to play with Grover, Big Bird, Oscar the Grouch, and the rest of them). You guessed it! It's because Big (pig?) Pharma wants to sell you insulin.

And Big Pharma is owned by the same people who own Big Media (hence the Sesame Street connection).

And may I remind you that pigs lay about in mud, and that mud contains so many pathogenic organisms that I can't even begin to list them. Just another reminder, I suppose, of the degeneracy of this 'diabetes-generation' who refuse to eat properly, and play video games all day long.

I'm getting tired just thinking about all of this. You know?

You know, as I write this, I'm reminded of that fake ADHD thing, also.

C'mon. Who doesn't get a little distracted? Full of energy? Impulsive? Encumbered by executive function deficits? Now THERE'S a classic example of lazy fakers pretending that they have neurobiological differences in their brains' basal ganglia components – the caudate, putamen, and globus pallidus – which researchers say present statistically significant consistently diminished volumetric measurement results. They just sit around all day, acting entitled, distracted, holier-than-thou, and unable to establish effective executive function activity due - or so those 'scientists' (big pharna drones) say - in part, and related to decreased right caudate volumes, and reversed caudate asymmetry, i.e., not the typical right-left caudate relationship. In addition, apparently these biased bullcrap and horse puckey studies noted a decreased volume of the putamen, reversed putamen asymmetry, and decreased volume of the right globus pallidus.

Yeah. Sure. And AS IF consistent evidence for a genetic association to the ADHD phenotype (note that genetic researchers like to make things up and are obviously geeks don't know how to relate to real people with strong moral values like hard work, etc... ) has been shown for markers in the DA (that's dopamine to you and me, reminding me that the researchers are a bunch of dope-fiends, undoubtedly) receptor D4 (DRD4), DA receptor D5 (DRD5), DA transporter (SLC6A3/DAT1), serotonin receptor 1B (HTR1B), serotonin transporter (SLC6A4/5HTT), and synaptosomal-associated protein 25 (SNAP-25) genes.

"SNAP"? Couldn't they think up something a little more original? Fakers. I bet that they also think Neil Armstrong and Buzz Aldrin actually landed on the moon.

Blah, blah, blah. Be careful. They'll try to convince you that a variety of brain subregions including the frontal and parietal cortexes, basal ganglia, cerebellum, hippocampus, and corpus callosum were found to be affected in ADHD.

Diffuse striatal connection abnormalities? Horse-puckey! Did your grandparents ramble on about functional MRI studies in children and adolescents with ADHD showing decreased connectivity in fronto-striato-parieto-cerebellar networks? No! Because they had strength of character. They were REAL. Salt of the earth.

Did Churchill, or Patton babble on about this connectivity being shown to be normalized by methylphenidate except in the parieto-cerebrellar functional circuit? No. Because they had responsibilities and decency and character and forbearance and worked hard and didn't whine all day long like a bunch of babies. They just worked harder.

Imagine someone saying that imaging techniques have pointed at three areas closely related to the basal ganglia, believed to be responsible for the symptoms of ADHD, the prefrontal cortex (part of the frontal lobe), the caudate nucleus (part of the basal ganglia), and the globus pallidus (part of the basal ganglia). Well. There's just one, uh, TEENSY WEENSY problem. How do you take someone's brain, take an image of it, and put it back into their skulls afterwards WITHOUT ANY ILL EFFECTS? YOU CAN'T! THAT'S JUST IT! ALL THIS RESEARCH IS PREDICATED ON A LIE - that living brains can be removed for study without killing the patients. Right? Are you following me still?

Listen. I could go on with this rant, but I've got things to do. I'm in the midst of a house move and need to find my ADHD medication.

Rant over.

Keep Calm and Take Vyvanse

2013-04-30T09:52:00.001-04:00

This is the shortest blog post I have ever written. Please enjoy the epigrammatic and succinct composition of the accompanying image.

A Response to a Reader's Question about Medication.

2013-03-28T15:09:00.001-04:00

I got a comment just now from a reader which included questions about their medications. They take methylphenidate and Strattera and are wondering about the length for duration, or of the overall effectiveness of their medication.

As a non-professional, I responded as follows, and hope that it clarifies my own understanding of medication as it relates to ADHD treatment. I would be very interested to hear from readers their thoughts on my perspective, and the advice I gave...

I wrote (I have modified it slightly for clarification below):

"Have you spoken with your doctor or psychiatrist? Methylphenidate and the amphetamine class of psychostimulants work for some and don't work for others - it can't really be predicted, depends on the individual. There are dosage aspects, metabolism issues, concurrent medication useage, and a host of other factors involved, not to mention your own personal level of change or stress due to situational factors (New job, school, city? Change in relationship status? Problems in your personal life? Are you getting sufficient sleep?)

Strattera didn't really work for me by itself, and I no longer take it. But I do take another NSRI class medication - buproprion (trade name Wellbutrin). Some of the NSRI meds can be useful in reducing some of the anxiety which may be brought on by taking the stimulants and may assist executive function, or so I understand.

What form of methylphenidate are you taking? Long release like Concerta or Adderall XR, or short release, like short release Adderal or Ritalin?

A good psychiatrist with a clear understanding and training in psychopharmacology should help you tweak your medication. I would definitely speak with your doctor about this, though.

To get the most out of your appointment, I'd recommend the following:

Try to track your cognitive senses throughout a few days in a notepad - i.e. Your focus level between 1 and 10, attention.

Track your emotions also - and your reactivity, irritability, grumpiness, ability to manage transitions or to shift out of hyperfocusing without being too pissed off(!). Basically, your level of attention self-regulation.
Track impulsive behaviors - interrupting, acting out, moving on to an inappropriate task or activity, when you should be sticking with the one you're already on.

Also try to document your ability to get priority items done, your ability to be organized, your level of overall 'effective functioning' in various arenas of your life. That is, how well you are managing at work, home, school, parenting, relationships, hobbies, sports, personal care, etc...

Bring this tracking information to your doctor / psychiatrist and it should help them better understand how to help you find an effective medication regime. Hope that helps.

Note that I'm not a medical professional, so just take my advice as you see fit. All the best, and let me know how it works out!"

Mungo

All Kinds of Stuff and Things and Objects Found in Boxes

2013-03-28T05:24:00.001-04:00

That's the best title I could come up with. It's 4 am, I just changed my daughter's very poopy diaper, and I figured that there's no time like the present to kick start my blog.

Just a heads up: Thumb typing on my Android might result in tortuous sentences, embarrassing hippopotatypos, and my 4 am brain might be prone to sentimentality - so be forewarned.

So. My house decided to get sold. So it is causing me* to pack up boxes of useful, important items, and boxes of useless, and seldom used crap. It is also causing me to wander about trying to figure out what to do next. It made a painter come in today (yesterday?) and massage paint into its tired seams, corners, and surfaces, and is working very hard to make me replace several basement ceiling tiles. I'm staying in Toronto. Hopefully close by. But the market's good, I am led to believe, and so it seems like a good time.

I'm fond of this house. And I trust that it wouldn't try to get itself sold unless it knew I could manage it, with an overload of big-life-things. It will encourage potential buyers to loosen their purse strings and cause my bank account to breathe a deep sigh of relief, encourage me to order pizza, and do what it can to have me settle in to watch some YouTube documentaries, or even go out and meet another human and do things involving hamburgers or cheese or something.

In the meantime, I'm looking for a contract or a full time gig.

I also started the ball rolling yesterday afternoon on a twenty year old dream of mine to get my Masters in psychology. Do what you love, right?

Here's a few things - in case you've made it this far into my post - you may want to know about what I've figured out in recent months.

1. I'm stronger than I ever thought I could be.

2. Everyone is carrying a frighteningly raw crate full of hurt, terror, longing , desire, insecurity, and fear within their psyches - and it is always demanding to be opened, and exposed to the searing light, and fresh air. Find a way to own it. Find out how to become acquainted with it so that it becomes your strength, and not your burden. And all that... And be decent to everyone you meet. But have a plan to fuck off (multiple egress routes) at the first sign that they wish to fuck you over. :-)

3. I have too many pants, too many shirts, and altogether too much stuff.

And so it goes**.

I was interviewed by a reporter from NYC a couple of weeks back for an article she was editing on Adults with ADHD, and it was published, and it was cool to read my experiences online in someone else's voice.

Also, I was interviewed last fall for a book coauthored by a Canadian psychiatrist specializing in ADHD, and a Harvard Medical School psychiatrist. It's now out, and look forward to reading a little snapshot of the story of how my own train wreck of a life, crumpled self-esteem, and hopelessness was halted by an assessment, and a subsequent diagnosis of Attention Deficit Hyperactivity Disorder (Combined Subtype) and Generalized Anxiety Disorder, and competent treatment. And how it was transformed into a full-on awesome adventure of rediscovering life, my strengths, my buried feelings, and (did I mention?) my strength.

Oh. Hey. After 20 years of drinking 8 to 10 caffeinated colas, and coffees a day, I figured to stop. So 34 days ago, I chugged back a Diet Pepsi, and haven't looked back yet.

I don't drink. I don't smoke. I don't drink caffeine. But don't cross me, and don't test me. And expect the worst in a knife fight in a dark alley, if you ever try to start one with me. Metaphorically of course. I'm not a violent person. I'll simple pin you down, wait for you to calm down, and let you go with your pride intact, but without your weapon.

But dear readers - I beseech you. If I ever tell you I'm going vegan, or some such nonsense, you have my permission to chloroform me, tie me to a chair, and once I've woken up, to force feed me a huge medium rare Porterhouse steak au jus, smothered in horseradish, with a side of baked potatoes. Thanks in advance.

There's a boatload more I would love to write, but there's only so much my thumb will put up with, now that I've been thumb typing for an hour, and my eyes are tired.

And for some reason I have Motörhead's Ace of Spades roaring through my head. So, time to sleep.

Actually, here. Listen.

Going back to sleep.

Love and danger,

Mungo

*Note that the house appears to have agency in my post. This literary device was inspired by the beautiful writings of Kurt Vonnegut.

** This animistic narrative transition is brought to you by the 116 occasions Kurt Vonnegut in which he used this phrase in his fascinating and raw book Slaughterhouse 5, a title inspired by the name of the building ("Schlachthof-fünf") in which he and other Allied prisoners were kept. In this building, they took refuge and consequently survived the horrific massive incendiary bombing (total of 200,000 incendiary devices) of Dresden, Germany in WWII which resulted in an enormous firestorm which engulfed 12,000 dwellings, killing in one night 20 to 25 thousand civilians, and which was brought to you by Marshall of the British Air Force, Sir Arthur Travers 'Bomber' Harris, AOC Bomber Command, and signed off upon by Prime Minister Sir Winston Churchill.

29 Quick Tips To Chew Upon for Adult ADHDers

2011-07-19T07:52:00.002-04:00

A few useful tips for adults with ADHD to chew on today:

Take time to meet with friends or a small group of adults. Don’t let yourself become isolated.
Exercise regularly. Find a partner, if possible, so you won’t forget to do it!
Find a quiet spot for yourself at home. Use it to relax, meditate & re-focus.
Use “pattern planning” to organize your days. Plan the same activities for same time each week.
Do not over-schedule your time. Learn time management skills & be realistic.
Make a list of ideas & “to do” items to free your mind for concentrating.
Review the items on your list, prioritize them, & cross of all you have accomplished.
Close your door, if possible, when you don’t want to be disturbed.
Build “flex time” into your schedule to allow for the unexpected.
Set up a study area away from distractions & set specific homework times.
Build in “break times” during long homework assignments. Use a timer.
Do weekly bag dumping after your work or school week. Dig deep & get out all that old “stuff”.
Devise a calendar of long-term assignments and projects to be carried in your notebook.
Get daily exercise. Walk or bike. Exercise helps to keep you & your brain focused & energized.
Learn how to be healthy. Eating good food helps to keep you focused, active & in a good mood.
Make time for frequent review & tossing of old papers. Set small goals of a few papers each time.
Mark what you read with a highlighter or flag important areas with small, colorful “post-it”s.
Tackle time-consuming & detailed projects in stages. Develop a plan before you begin.
Use your high productivity hour for your most important project & most difficult homework.
Get educated about AD/HD. The more you learn, the more you can work WITH it & not against it.
Keep a family calendar at home or online using a shared electronic calendar (e.g. Google Calendar).
Design systems & guidelines for the family that is mindful of each person’s needs.
Avoid morning chaos by getting everything “ready to go” for work & school the previous night.
Become well educated on co-morbid / co-existing conditions.
Plan regular friend & family outings. There are many activities that are low cost or free.
Take a “team” approach to problem solving.
Work together to get organized. Chunk down tasks into small steps for those with AD/HD.
Set a scheduled family time every few months for tossing unused items, old clothes & old newspapers.
Work toward a better understanding of friends & family members with AD/HD. There are gifts in each of us.

Cheers,

Mungo

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I'm Back, Baby, I'm Back - Vyvanse and Adult ADHD

2011-07-02T23:05:00.005-04:00

Well, hello everybody. Yup. It's me. Yup. I know. Nearly 3 months. Nope. I wasn't in prison. Nope - didn't get lost in the woods. Nope - not in Guantanamo Bay, either. Nope - didn't enter a fugue state, turn up at a McDonald's in Oregon speaking Dutch, claiming not to know my own name. Nope - not kidnapped either.

I've been here and there getting things done, and I think I was kind of waiting to get attuned to a new job (a contract position), new medication, and a new daughter (she's 3 weeks old and now our 2 1/2 year old boy is a big brother...) before writing more about my progress and journey.

I'm here and in good spirits. In fact, the best I think I've ever been in.

The last three months have been great - in large part to the new medication I'm on. I returned to the clinic I'd initially had my diagnosis at, and saw a psychiatrist who was recently the president of the Ontario Psychiatric Association for a second opinion. He was terrific. So I went off Strattera, and as soon as it cleared from my system, started taking a drug called Vyvanse to manage my ADHD symptoms. For me, it was nothing short of incredible. I started at 20 mg, and have now moved up to 60 mg. I initially called it my James Bond 007 medicine. More on that later. In fact, Vyvanse works so well for me that I almost feel that I wasted nearly a year on Staterra.

Vyvanse is essentially an extended release formulation of Adderall and was approved only in January of this year in Canada. It has been around in the U.S. for much longer, and of course is essentially Adderall - a well-proven psychostimulant which has been around for decades. What's different is that some clever chemists attach a lysine (amino acid) molecule onto the dexamphetamine, and ended up with the delicious-sounding lisdexamfetamine dimesylate. This pharmaceutical processing makes Vyvanse a prodrug - a pharmacologically inactive compound that require in vivo (in your body) conversion to release therapeutically active medications.

The prodrug aspect of Vyvanse achieves a couple of goals:

The first is to prevent the abuse of the drug, because the only way you can metabolize it into the stimulant dexamphetamine is by first orally ingesting the medication (gulp) and thereby allowing the drug to pass through your small intestine into your blood stream. It is on the surface of your red blood cells - after it has been absorbed through the microvillae on your small intestine's wall - that the lysine is cleaved away from the dexamphetamine, thus making it 'bioavailable'. So this precludes someone snorting the pill, or injecting it into their arm to get a quick rush. But from what I understand, even if you took a lot of the pills, their is still somewhat of what I call a metabolic turnstile, such that your body can only metabolize a certain amount of the prodrug at a certain maximum rate - so you wouldn't get an abuse-worthy amount of meds in your system if you tried.

The second goal is related to my last point, in a way. The medicine is metabolized at a given fixed rate - based on your system's 'throughput' rate and in this case, the psychostimulant is released in your bloodstream body over a period of up to 14 hours. This sustained, smooth release allows for full coverage throughout your waking day into the early evening - and doesn't give you a crash at the end.

And so I return to the James Bond 007 reference from earlier. The first week I was taking Vyvanse, I noticed clear and positive cognitive effects, and virtually no physical side-effects (other than some minor dryness of my mouth, which passed after a few days). I could focus appropriately and without effort. No longer did I unintentionally scoot from thought to thought, activity to activity, daydream to daydream and from topic to topic during a conversation. I stayed on track. I felt as though my situational awareness was heightened - yet controllably so. You can imagine a scene in a James Bond movie, or in a movie like the Bourne Ultimatum where the secret agent is in the middle of a mission requiring his full attention. This attention comes from a combination of extensive training, rehearsal, knowledge, physical fitness, mental acuity and a strong sense of confidence. Thus James Bond walks with sureness, certainty, does not get sidetracked, and goes about his dashing, albeit lethal business. Although in my case, the business does not involve blowing up embassies, shooting bad guys and rescuing wailing dames from the grips of deranged sociopathic baddies. Generally speaking.

Within a few weeks I stopped being so aware of my increased focus - which makes sense. I think I just got used to this improvement. But cognitive effects aside, the way I know that Vyvnase is really working for me is with my external environment, i.e. the world around me, the things on which I have agency and the world in which I take action.

My personal Action List, comprising all the large and all the minor things I need to complete in every arena of my life, which I have been diligent in gathering and maintaining over the past year, has decreased in length. Now it isn't often that a decrease in length is considered a significant selling point for a medicine (ba-dum-CHING!), but I have been able to tackle the really big projects on my list and been able to remove a lot of items from my list. I am acutely, almost painfully aware that I have a life-time of deficit to catch up on, and so I've been running at full steam to get things done - propelled both by excitement and happiness and indeed by a newly found focus. I can see the list diminishing, and with each item crossed off, I get a little bit stronger and gain a little bit more pride in myself. I suppose you could say my self-esteem is improving.

And as a result of going on Vyvanse, I've had a few insights. One of them is that I've learned a large part of my difficulty with getting projects done was a combination of 1) my poor (neurobiologically influenced) pre-conscious attention modulation resulting in me rapidly turning away (without being aware of this) from thoughts of daunting, uninteresting complicated or mundane tasks, and 2) a life-long paucity of experience and learned competency with organization, planning, and coping skills. That is, 'was never good at it, so never learned it, and so now has to learn it'). And between my deficient and neurobiologically impaired attentional capacities, and my deficient executive-functioning skills lies a set of deeply engrained core schema beliefs about my ability to sustain and achieve real change and to attain a competent sense of agency & control over my environment, personal & work life, and relationships with others.

Another insight is that it would have been really (REALLY) nice if I'd been identified as having significant attentional problems when I was a child. Scanning through my grade 4 report card, I read the following note:

"He is is obviously a capable boy as his contributions at group time and comprehension reveal - oral, reading. He is also quite fluent. This ability is not reflected however in his written work which appears often hastily completed. At times he is disruptive to those around him and as well he's easily distracted. His projects cover a lot of material but lack organization. Record keeping was accurate but could have been presented in a neater fashion."

So I was a capable boy, engaged and interested in working in a group, and demonstrated good oral, verbal and reading abilities. I was seen as disruptive (i.e. impulsive). Easily distracted. Hastily finishing work due to poor organizational and time management skills. Demonstrated lower than normal executive functioning as seen in my poorly-organized written work (as compared to my otherwise notable conceptual abilities). Messy record keeping indicative of comorbid dysgraphia. I'm sorry - HOW did my parents, teachers, guidance counselors, and other involved professionals NOT see ADHD as a strong possibility, or at the very least, refer me for professional assessment? Forget most of the items - let's assume all of the adults were half-asleep, hungover, or preoccupied with much more important things. What about the 'disruptive and distractible' parts? C'mon, folks. This wasn't the 1950s. This was the late 1970s and 1980s where guidance counselors were lining up, salivating at the opportunity to deal with my confounding combination of high potential, high intelligence, ravishing good looks and very low performance. And NONE of them saw a pattern in the chaos.

I mentioned earlier that I feel that I'm catching up with a lifetime deficit of getting things done, resulting in a long list Action Items which I need to take care of. And in the same way, I'm catching up and dealing with a bunch of emotional baggage. As I get healthier, and stronger and begin to get more perspective on my life, I begin to feel quite sad for me: for that strained, hopeless, frustrated, 'lazy and helplessly stuck' kid, that teenager, that young adult who suffered so exquisitely with all of the symptoms and the consequences of severe ADHD, combined subtype. And with that comes anger, and some wondering of how I managed to slip through the cracks. And yet at the same time, I recognize these feelings are natural - and that probably every adult who is late-diagnosed with ADHD goes through the same motions and emotions. And I hope to cover off more of this in future posts.

Switching gears somewhat, I have to make clear that while Vyvanse is working for me, it is truly 'to each their own' when it comes to medication. Physicians can use a variety of medications to treat and address the neurobiological / cognitive symptoms of adult ADHD. Each individual reacts differently to the various medications, depending on their metabolism, the expression of their genes, existing psychiatric comorbidties (anxiety, mood disorders etc...), confounding non-psychiatric conditions, other medications they are on, the ADHD subtype ('maybe' - this is something I came across recently), and the medication treatment regime and circumstances (titration rate, dose - not too little, not too much) - and effective, appropriate medical follow-up. And I'm sure there are several more factors I'm missing. The long and short of it is that medication works for ADHD, but you and your physician have to figure out the right medication through an empirical, educated, and trial-and-error approach.

And while the psychostimulants can work quickly - and result in remarkable changes in a person's life - the other pieces of the treatment arsenal have be brought to bear. The most effective treatment is a combination of medication, psychoeducation (i.e. learning about the disorder and the various techniques, coping strategies and skills that can provide relief) and psychosocial interventions including individual, group, or family counseling and ADHD skills coaching.

Those other pieces of the treatment arsenal will have to wait for future posts, though. It is late, and I am tired.

Hope you're all doing well. I'm glad to be back.

Mungo

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Drug Free and Waiting To Go on More Drugs...

2011-04-04T12:51:00.005-04:00

Today is my first day without Strattera in my brain and blood for nearly 10 months. This way, I'll be able to go on Vyvanse (hopefully quickly) and be able to discern effectiveness without any conflicts due to another medication. I am very hopeful for this change.

Last week as I was coming off the medication, I have found myself excessively chatty (still happening). I noticed people 'casually' looking at their clocks or even saying "Well, I have some things I have to do now..." as my conversations ran on and on. My conversational skills are surprisingly interesting to me. No matter what others think.

Plus I have been quite fidgety. My right leg shakes up and down almost non stop. I should take up playing the spoons. Shaky shaky shaky. I shift in my chair a lot. I walk about during breaks to help me clarify next steps - which is a deliberate attempt to make explicit some working memory improvement techniques I am trying. I think it helps. I talk to myself quietly - "Okay, I must do X, Y and then Z..." and get it straight in my head before launching into a frenzy of productive energy. Were I not to plan it out, I'd likely launch into a frenzy of frenetic, unguided, unproductive activity...

Tomorrow I'm going to my family doctor to follow up on the psych consult I had recently, where the psychiatrist concluded that I should come off of Strattera and go onto Vyvanse. I have become inured to the fact that delays in my medical treatment will likely keep on happening. Heck, it has taken me 40 years to find out I have ADHD, so what's another few years?

Official prediction: I will go to my family doctor's office tomorrow and he will insist that I take a panoply of tests prior to getting the prescription (despite having had heart and blood tests for Strattera just 10 months ago). This will inevitably lead to a delay, and I won't get the Vyvanse prescription until a period in time when everyone will have their own private flying car, when all you will need to eat in a day is a single condensed pill with a glass of synthetic orange juice, and robots will have replaced the need for us to work.

I would rather lower my expectations and be surprised (i.e. get a prescription for Vyvanse immediately following my appointment tomorrow), than have high expectations and be disappointed, despite the fact that I oughtta know better by now.

I hope I'm wrong.

:-)

Cheerios,

Mungo

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Feeling Somewhat Irritable and Likely Projecting Upon Others

2011-04-01T14:00:00.005-04:00

Next week I have my appointment to get changed over to Vyvanse. I'm looking forward to it, and feeling optimistic and excited. Well, that's what I'm feeling now.

But (I suspect) because I'm coming off the Strattera, and due to lack of sleep (staying up too late, possibly again due to titrating from 80mg to 30mg in less than a week) - I am especially grumpy, grouchy, touchy, irritable, and ever-so-slightly holier-than-thou today. So back the heck up (insert variation of wording as you wish) and get the heck out of my way.

So I wanted to make sure everything was in order for my doctor's appointment next week (and see if you can follow this):

Yesterday I checked in with my family doctor to see if the consulting notes and recommendation to change medications had been sent through to them, just so that I don't waste time driving a long way to another town to my family doctor. The assistant told me that it might have come through, but likely my doctor hadn't gotten to it yet as he'd been away and had a stack of papers on his desk 'this high'. I thanked her and she told me that she was sure he would get to it. But to be sure I phoned again today to confirm and she told me (as she checked my file while I was on the phone) that it had NOT come through. So I phoned the clinic back and the assistant there told me that the fax machine didn't work correctly on Monday so it hadn't gone through. She couldn't see that I wasn't blinking, and forcing a smile over the phone and so I asked her if she could try sending it again and that I'd call back in a few minutes to confirm that it sent okay. She said 'well, hold on... okay, there.' and it was sent. Just like that. Literally in seconds. So I thanked her, checked my family doctor's office and it had indeed gone through. I rolled my eyes and shook my head after hanging up.

And all the while I'm charged up and thinking 'goddammit how incompetent are all the people I'm dealing with this week?'. See, I am also working hard to push a project through in my new job and the third party contact is about as responsive and timely as a sloth on barbiturates. And no doubt, far less adorable.

Sure - I find customer service can be pretty lackadaisical at times, and realistically, most folks reading this would agree with me that at least a few of these situations involve folks who are not moving their derrieres in an effective manner, on time and under budget as it were (I'm a project manager, can you tell?).

And I could begin listing about a dozen more instances of irritating situations where people were taking their time getting things done... but I won't bore you with that. And anyway, it kinda would obscure my purpose for this post.

Here's my point: I obviously recognize that there is a common denominator to these scenarios. Moi. The one person who is consistently engaged in trying to solve a problem with all of these other unrelated people is little ol' cutie-pie me. Could it be that I'm projecting just a little bit?

"Our own projections are difficult to spot, first of all, because we don’t want to identify them as such: the whole point of projecting is to rid ourselves of something unwanted. While there are instances where people project their good qualities into others, ridding oneself of painful or unpleasant experiences is much more common."

Maybe it is because I'm coming to recognize an uncomfortable truth about myself, which is that often I'm the one who doesn't get around to things in a timely manner (if my lovely, and somewhat long-suffering wife is reading this she might agree!).

Charge me up with dopamine, norepinephrine, an intense emergency situation or anything that really commands (for some reason or another) my intense hyper-focused awareness and I'll blow through it like Evil Knievel on a motorbike. Like Han Solo in the Millennium Falcon. Like Chuck Norris in a bar fight. Go orbitofrontal cortex, go!

But so many times I am dimly aware of a set of important to-do tasks I'm leaving on the back burner, undone and unheeded.

"Projection is an unconscious fantasy that we are able to rid ourselves of some part of our psyche by splitting it off and putting it outside ourselves, usually into somebody else. While the initial process occurs outside of awareness, maintaining or insisting upon the reality of that projection often occupies our conscious thoughts. The process is usually distinguished by its focus and intensity."

So I note with considerable discomfort and with some shame that I am projecting to a large extent. I need to remind myself that I too don't always get things done at the speed of light. And that I don't always put other people's priorities on my own priority list. That I don't always empathize and spend my time ensuring others are considered. Or simply put: I am not always that considerate and responsive to the important people around me.

I guess 'owning my projections' means that I need to find a way to reconcile my own conflicting feelings and beliefs about myself and others. That is, why should others have to be completely efficient, competent and effective when dealing with me, but I can been inefficient, incompetent and ineffective when others deal with me? Is there a middle ground? There has to be a middle ground.

But in the meantime, I'm dealing with this in two ways: 1) biting my tongue while dealing with people when I need them to do something , and 2) making sure I diplomatically and considerately ensure my priorities are taken care of in a timely manner. This way I don't end up driving people away, and at the same time, make certain I take care of my needs so that I can get more healthy, grow up, do a good job at work and in other arenas of my life.

Comments are always welcome!

Mungo

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Changing from Strattera to Vyvanse for my Adult ADHD - Very Excited!

2011-03-30T13:12:00.002-04:00

In the last year, I have been relentless in my quest to ensure I take care of myself and get effective treatment for my ADHD. But as stubborn and determined as I can be, the medical system's wheels turn slowly. Or at least they were from where I was standing.

The non-stimulant SNRI 'Strattera' worked pretty well for a while. I think I had better control over my impulsiveness. My multiple channels of thoughts seemed to quieten down, and I was able to have two or three things going on in my head at a time - that's quiet for me. I could focus much better. I would take a breath before saying something and often times decide not to say something.

I remember just as I was starting medication becoming aware of how I always had four or five trains of thought going at once - and how I thought this was perfectly normal. I would be thinking of the situation at hand, then something perhaps about a previous situation similar to it, and then something completely unrelated, like a task I needed to do, and maybe a thought about some sort of philosophical point, and perhaps something about the etymology of a word that I had just heard in the conversation, and then maybe what I was going to do next, plus maybe something I wanted to excitedly add to the conversation, even though it was not pertinent.

Looking back, that's a lot of stuff happening all at once. No wonder I got distracted easily, and no wonder I spaced out a lot.

Strattera seemed to calm my thinking down and reduce my impulsiveness, as it relates to interrupting conversations, inserting non sequitors, or adding humour at inappropriate times.

But the spacing out, the perseveration, the procrastination, the difficulty I have with attending to priority tasks - was still a big struggle.

And my family doctor is - uhm - well, he isn't really good at customer service. He isn't the guy in the department store who answers "No, I don't know if we have those widgets, but walk with me and I'll introduce you to an associate who knows the department better than I do, and we'll make sure you leave today with either a widget or knowing where to pick one up in this city - we'll call our competitors as needed". No. My doctor is the type of guy who answers "No, haven't heard of 'widgets' - we don't sell them."

He's never - other than asking me if I am having side-effects - asked me in depth about Strattera, and ADHD.

So I started asking around, and phoning around for someone who could give me some answers. After multiple tries, I still wasn't able to get to a doctor who understands Adult ADHD, someone who specializes or at least has some knowledge of it. But the very helpful doctor I went to (who I found through a different channel) suggested that I return to the clinic where I got my assessment done and inquire there.

Well, that worked. I got a call back after half an hour, and a week later attended an appointment with a psychiatrist who is a very senior member of the Canadian psychiatric community, and specializes in Adult ADHD. He is also trained and specializes in psychoanalysis, which is one of my considerable interests. Best of both worlds.

Anyway, my meeting with him lasted for about 45 minutes. It went as smooth as silk. His recommendation was to come off of Strattera. He was genuinely puzzled as to why they recommended a 'second-line' medication for me. He sent a consult recommendation to my family doctor (groan) to put me on Vyvanse, a psycho-stimulant.

I'm very excited about this turn of events. Finally! So - next steps are as follows:

1) Make an appointment with my family doctor (who is out today) so that he will prescribe me the Vyvanse according to the regime that the psychiatrist recommends (i.e. increasing, titrating to effectiveness)

2) Stop taking Strattera. While most accounts say that there are no discontinuation symptoms, I'd rather taper it off, and given the number of capsules I have left, I'll have completely stopped this coming Monday:

Monday, March 28: 80 mg
Tuesday, March 29: 70 mg
Wednesday, March 30: 50 mg
Thursday, March 31: 40 mg
Friday, April 1: 30 mg
Saturday, April 2: 20 mg
Sunday, April 3: 10 mg
Monday, April 2: No more Strattera

I'll keep an eye on symptoms that emerge after coming off Strattera, and just hope that there won't be much of a gap between coming off Strattera and going on Vyvanse.

Cheers,

Mungo

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Please Visit Blogs on the Blogroll

2011-03-18T07:44:00.002-04:00

Good morning everyone!

Just wanted to ask y'all to consider visiting the various blogs on my blogroll located at the bottom right of this page. Each and every one of the people who write blogs there put their hearts and souls into their efforts, and I've learned that building a community of like-minded, understanding people is very important.

Thank you in advance, and I hope you encounter new online connections this way.

Cheers,

Mungo

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Video: Overview on Current Trends and Controversies regarding ADHD

2011-03-14T09:36:00.003-04:00

I came across a terrific video about ADHD this weekend. It is very educational, and I highly recommend that you watch it. Dr. Pommer is a Clinical Psychologist, and his primary area of treatment is Attention Deficit Hyperactivity Disorder (ADHD).

In this presentation, Dr. Pommer provides an overview on the current trends and controversies in the diagnosis, misdiagnosis, associated conditions (depression, anxiety, learning disabilities, etc.) and treatment of ADHD.

Cheers,

Mungo

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I'm Forgetful & Freezing Cold

2011-03-11T13:36:00.002-05:00

Having forgotten to take my Strattera this morning, I'm finding myself awfully forgetful and - strangely - very cold. I have my winter jacket on, zipped up high. In the office. Could be just a cold coming on.

And the forgetfulness? Well - who knows. I'm not sure what typical effects would be if someone forgets their SNRI for a day. A stimulant, well - the effects of missing a dose is probably quickly evident. But SNRIs are slow to act, and last for 24 hours. Maybe I've still got some in my blood from yesterday. And maybe my nice little orbitofrontal cortex has decided to give me a break and chosen not to completely fall asleep.

Hope everyone is having a nice Friday.

Mungo

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Whoops, Forgot My Medication Today...

2011-03-11T08:42:00.003-05:00

For the first time in nearly 10 months since I've been taking Strattera, I forgot to take my tablets this morning. I was in such a rush because I wanted to get to work nice and early. I got to work at 7:20 am. Grabbed a coffee. Wrote my daily work priority list. Reviewed e-mails. Reviewed my schedule.

Then realized I'd forgotten my Strattera.

I wonder if I will notice any significant effects, i.e. worsening of attention or increased impulsivity or hyperactivity? I wonder.

Let's see how the day goes. Pleased that I'm doing my daily priority list and getting in early to get a productive start on the day, though. That's gotta count for something!

Mungo

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Benefit in the Long Term by Delaying Impulses in Adult ADHD

2011-03-09T11:39:00.007-05:00

I bought Dr. Russell Barkley's "Taking Charge of Adult A.D.H.D." recently, and I want to recommend it. It is a terrific read - I'm finding it to be extremely practical and helpful. He writes how fundamentally there is a diminished ability to control impulses with ADHD. He presents several principles and practical methods to address ADHD symptoms. One principle is to "Stop the Action". Here, ADHDers should put some delay or obstacle between an impulse and subsequent action or comment, thus allowing the executive region of the brain to fire up and contribute to the thought process, thereby enabling verbal and non-verbal working memory to kick in and help find a socially acceptable way to moderate impulses.

The trouble with ADHD is that planning and reflective thinking ('executive thought processes' which take place in the orbitofrontal cortex) is often bypassed, leading to impulsive actions, as opposed to preplanned, consciously moderated actions. This may be due to neurological structural differences in the orbitofrontal cortex of ADHD brains.

So one method of putting a delay or obstacle between an impulse and subsequent action or comment is to gently bite my tongue or place a finger over my mouth (while looking thoughtful). I reason that it is better for me to be seen as a bit of an odd duck constantly biting my tongue or placing a finger over my mouth during a conversation or meeting, than to be viewed as someone who says something impulsive - albeit possibly true and incisive - but ends up distancing or alienating the person who I am addressing, thereby negatively affecting my relationships.

Another method to help insert executive thought moderation into the 'impulsive path' - which an ADHD brain is highly geared towards - is to quietly talk through the task in which you are currently engaged (like writing a blog post, or planning an appointment or meeting), visualize next steps, and recall previous similar circumstances either earlier performed by oneself, or seen performed by someone else. If you are shy about talking out loud, you could stick one of those blue-tooth headsets on your ear and make it seem like you're on a phone call... or just quietly mutter to yourself. Again, better to be seen as someone who talks to themselves (everyone does it!), than to be regarded as an impulsive, rude or awkward person.

This method of stopping to think and to verbalize your recall and planning not only helps you to establish a repertoire of working memories (in which you are likely deficient, as an ADHD Adult) which will help you in the future to delay impulses, it also helps you to gain access to memories in the moment that will help you perform in a way that will benefit you in the long term.

By using this method, you improve your chances of gaining long term benefits and diminishing the effects of disruption, discomfort, and interpersonal troubles which result from acting upon your impulses.

Cheers,

Mungo

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Poem: Dream of a White Coat

2011-02-18T10:41:00.003-05:00

I wrote a poem a few years ago. I was struggling a lot then. I think it is about trying to find a common thread through all of my different interests and periods of life.

Freud wrote in The Interpretation of Dreams that dreams are usually overdetermined, "in that they are caused by multiple factors in the life of the dreamer, from the 'residue of the day' (superficial memories of recent life) to deeply repressed traumas and unconscious wishes, these being 'potent thoughts'".

In that same way, I believe that poems are overdetermined. In fact, I think adults with ADHD are particularly sensitive to the fact that even everyday conversations are often overdetermined, which I think can account for some of the distraction we all feel during talks with friends, family & colleagues. We read subtle interpersonal cues that reveal much more about the speaker than words would suppose.

But I digress.

Dream of a White Coat

this dream never really died
it just transmuted into the unrecognized
carried in me like a body on a stretcher
and laid out for visitation
on a foggy Irish night
in a cottage
with whiskey and bread

it wore a white coat when I was young
a paramedic

it wore a white coat when i was in high school
late night studies of chromosomes and lysosomes

it wore a white coat when I became a butcher
and it wore a white coat finding dreams in the library stacks

it wore a cheap suit in an office where it cried
and none would argue it tried to appear
but I don't know where it went
maybe up north on a site by a tent

Thanks for reading,

Mungo

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Job Searching, ADHD Style

2011-02-06T04:00:00.002-05:00

It has been 10 weeks since I posted last - I took a bit of a break from writing to focus on work issues. I left my job working at a broadcast company, and am lucky enough to have received a package which will help me through for a while, while I looked for another job. The holidays were nice, and I got to spend a lot of time with my wife and our little boy, who turned 2 last week.

Recently, I somewhat presciently wrote about Adult ADHD jobs and workplace issues. There I wrote about how impulsivity, distractibility and hyperactivity can be difficult traits to have at work, and how these symptoms can have a negative impact on you.

The feedback I got on that post was heartening, and many people added comments about their own experiences. This is what I love about writing this blog - it is a place to connect with people who share similar experiences. Hearing about this makes my journey a less lonely one.

I'll say this: Looking for a job is a full-time job! I used various job search web sites, used LinkedIn.com a whole lot (feel free to connect with me there and note that Mungo is my nom de plume), and followed a colleague's advice to network, network, and network some more on LinkedIn. In the end, this is what got me connected to an agency which found me a contract position. I am starting Monday.

A job gives me daily structure. So does having a little boy who wakes up before 6 quite often, and has to get to daycare, and have his dinner and bath and bed time at a regular time. External structure is critical to me, so I have learned and viscerally learned and relearned over the past year. So having a regular 9 to 5 job is important.

When looking for a job, it is important to maintain a sense of schedule. Try to keep your days scheduled. You may need to have a few pajama-days, and take-it-easy days - because often it is hard to leave the job search when the 5 o'clock whistle blows... but try to have breaks. Go easy on yourself. Expect a roller coaster of emotions. Expect disappointment and strong emotions to arise and fade away as you attend interviews, get rejection notices, don't hear back, and heal from wounds from your previous job experience.

Connect with friends and family. Try to be open about your feelings about the job search. Accept advice and help.

Sometimes you will be called for job interviews for a job you know at a gut level isn't right for you. Attend it anyway, if you can. Interview experience is important. You often will learn something from each interview. It might be a question you didn't anticipate, and end up thinking about afterward. It may be your gut reaction to an interviewer or the location - you'll learn better to trust your instincts about whether you want to work for this person and company or not. You'll learn better how to dress for an interview. And so much more.

I found organizing my interviews and scheduling follow up calls and e-mails difficult. I used my Google Calendar to post reminders and the second I got an interview or a pre-screening call scheduled, I would add it to my calendar. If I didn't, I might end up writing it on a scrap of paper and then forgetting as I tend to get quickly distracted and leave my thoughts behind as I move on to the next thing...

Read books on ADHD to help you keep coping mechanisms in mind. The book I'm reading currently is Taking Charge of Adult ADHD by Dr. Russell Barkley. This is probably my favourite book so far on Adult ADHD (I own and have read about a dozen books in the past year since my diagnosis). I can't recommend this book enough - every adult with ADHD should read this great source.

Try to take some time for yourself. Go for walks or go and see a movie. Be kind to yourself.

I am really relieved to be starting my job on Monday. It will be an exciting role. I incorporated myself as part of the process to work on contract through an agency - it pays better that way, and I can write off certain expenses. That was a process which my lovely wife helped me with - she is really good at organizing and at paperwork. She helped me enormously through the past couple of months, and I thank her very much.

Take care everyone and be well.

Cheers,

Mungo

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I'm Back, Baby, I'm Back...

2011-02-03T08:31:00.001-05:00

Folks, it has been too long. A lot has happened since I last posted in October, but I'm back and ready to start writing again.

Hope all is well with you. More very soon. :-)

Cheers,

Mungo

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Memory & Sleep & Something Else But Can't Remember

2010-10-28T09:55:00.003-04:00

So this is a quick post, coming after having had a poor sleep for nearly a week. Our little boy got sick with a virus, and had a rash and joint swelling. Poor little guy couldn't walk with the pain, and he hardly slept. Lots of crying (him, not us...). He is feeling better, and my wife is staying home today and tomorrow to be with him. Poor little guy.

I've been sick myself. Another accursed headache this morning - I've popped some Tylenol.

Like a lot of experiential knowledge, you just don't know until you know, but this I feel exquisitely this morning: lack of sleep exacerbates memory problems. And all the more so if you have ADHD, i.e. where you have a pre-existing memory condition. I write about working memory deficits elsewhere in this blog.

"[...]adults with ADHD are thought to have deficits of working memory as exemplified by less ability to attend to, encode, and manipulate information. Such deficits in working memory may decrease the ability to filter out distractions, which contribute to further symptoms of inattention in adults with ADHD."

I forgot to put the recycling out this morning. I haven't forgotten in a LONG while. I forgot a bunch of things and have been procrastinating getting things done. Admittedly, it is hard to do work, and cross off to-do list items when you're taking care of a little one, so I'm not being too hard on myself there... but the memory thing is quite tangible today. I am going to keep my notebook with me at all times today (my personal 5" by 7" paper notebook in which I record to-do items and notes).

I will return to writing shortly - hope all is well in your world,

Cheers,

Mungo

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Adult ADHD and Workplace / Jobs & Employment Issues

2010-10-15T08:00:00.004-04:00

I went to a seminar at the Ontario Science Center earlier this year to hear psychiatrist Umesh Jain, and ADHD advocate, writer, and comedian Rick Green talk about Adult ADHD. The topic being discussed at that point was employment difficulties for adults with ADHD. The person who sat beside me leaned over and told me that she'd had over 35 jobs and that she was 35 years old. I was stunned - I think I was at 17 at that point, at age 39 (more below). It was not such an uncommon story amongst other audience members.

Sitting there in the audience, I was stunned to see over a hundred other adults who had been diagnosed with ADHD in their adult years. They all looked normal - no prehensile tails, no little horns... and at the same time, I felt like I was with a group of people who understood everything about my struggles. Because they'd gone through them too. It was uncanny, it was almost surreal. I had not yet been diagnosed, and had been recommended by a therapist to look into an assessment.

But back to jobs.

The typical diagnostic triangle for Adult ADHD is impulsivity, distractibility and (generally mental) hyperactivity. This does not bode well for an employee at a conventional office workplace.

Impulsive comments and behaviours can flag you as erratic, unusual, weird, and lead to you being excluded from the group to which you belong. Being in management as I am, this can be disastrous, because trust, conformity and communication is key to management relations (perhaps more so than in non-management roles).

Being distractible will help ensure that you never quite get priority items done on time, because you're off on a tangent and never sticking with that documentation or presentation you needed to get completed. Not delivering on deadline can be a career-limiting habit. Plus you'll miss essential discussion points during meetings and probably be perceived to be annoying as you keep looking at your BlackBerry, or out the window, or start twirling your pen in circles around and around and around and around and around. You will not be perceived as being 'present'. People may regard that as disrespectful behaviour, even though it has nothing to do with disrespect, and everything to do with attentional inconsistency.

Hyperactivity - which in adults becomes internalized as opposed to the stereotypical whirling dervish child, racing from place to place, screaming out loud - becomes internalized as the adult develops coping strategies over the years. Hyperactivity presents in the Adult ADHD individual as fast thoughts and speech. You may talk so much and so intensely that no-one gets a chance to add their own perspective and opinions, and you'll have a difficult time getting to hear and learn about other people. Getting to know other people is important at the workplace, and if you don't develop relationships based on mutual understanding and respect, you may be shunned from the group. It is quite annoying to be on the receiving end of someone's fast-paced talking. And because they're thinking so fast, they'll be jumping ahead in topics faster than the pace of the average person, and be perceived as being erratic and disjointed in thought - even though they actually are simply naturally progressing through the topic as you would - if your brain was sped up.

These symptoms have affected me negatively at all of my jobs.

Since I left university (where I studied cognitive psychology), I have worked as the following:

Butcher
Support Worker for developmentally handicapped adults
Counselor at a custody facility
Developer / Programmer
Lead Developer
Project Manager
Production Manager
Project Manager (contract)
Business Analyst / Information Architect (contract)
Project Manager (contract)
Operations Manager
Project Manager (contract)
Development Manager
Program / Project Manager (contract)
Project Manager
Project Manager
Applications & Systems Manager

17 jobs in the last 15 years. The first 15 jobs took place over the first 11 years. The last 2 roles have been at my present company and have lasted nearly 4 years. This is a good trend, I'd say.

And now, since I have been diagnosed and taking treatment and medication for Adult ADHD, I see my successes at work increasing, and my satisfaction improving. Work can be hard and trying for all, and for those with Adult ADHD all the more so. I may even have more jobs to add to this list in time, but I now know that my experiences will improve and my struggles will lessen. This gives me great hope.

I would love to hear comments from other folks about any ADHD related employment stories - do share!

Cheers,
Mungo

The Racing Thoughts of Adult ADHD

2010-09-22T21:45:00.010-04:00

For all of my adulthood, I have gone to bed very late. Now that I am getting some perspective on ADHD, and learning about the symptoms, and the neuropsychological underpinnings of the disorder, I can understand why. I never wanted to lay down in a quiet bed and listen to my brain revving, so I would exhaust myself until I literally passed out. Or in the past I would have a few (or more) drinks. That would dull the cavalcade of mental imagery.

Imagine you've got a nice vintage Mustang car. You've got it in your driveway. Your friend drops by and asks if he can sit in the driver's seat and turn on the ignition to hear the classic engine. You answer "yes, go ahead". He smiles, turns the ignition over and then jams his foot down on the pedal and the engine races out of control, your eyes bug out and you feel out of control. That's what it can be like with ADHD.

I think fast. I talk fast. I read fast. People have always commented on the fact that I can read a page of text about 10 times faster than Superman. But this isn't like bipolar disorder where there can be an unceasing pressure to spit words out, and often the utterances end in nonsense. Where the thoughts are inchoate, indecipherable jumbles of ecstatic confusion. No, this is simply because my brain runs very fast, and I either talk quickly or think quickly. If I can match my thinking and actions with my environment, then I feel in sync and I feel okay - assuming I am populating my environment with activity and excitement (TV channel surfing, internet surfing, multi-tasking, talking, reading several books at once, engaging in several hobbies - you name it). But turn down the tempo on my environment and then I become uncomfortably conscious of the tempo of my thoughts, the racing, the sensation that I cannot control the speed of my thoughts.

So I don't go to bed until I'm worn out. I can sit by myself for hours, but I have to be reading or doing something. I going solo camping, but I'm always exploring the woods, or collecting firewood, or cooking, or arranging. Alone with my thoughts, yes, but always matching the tempo of my internal world with the tempo of my external world.

I described the train of thoughts in my head to the psychiatrist in my assessment back in April/May like that of a a lumberjack who is racing on rotating logs in a river. You have to keep running lest you tumble into the water and get crushed by the massive logs. It is beyond your control.

As I was falling asleep (or at least trying to) a couple of weeks ago, I came up with a new metaphor. I imagined a large boiling pot of soup with chunks of vegetables and chicken and such in it. Each item that boiled to the top was a thought, quickly to be replaced by another totally different one - over and over and over. I am now able to describe accurately a mental experience I've had for years: I'll be thinking (either as I'm laying in bed, or just generally during the day), and have an intriguing, or useful thought, and then all of a sudden it will be displaced by another train of thought - and I'm only left with the sense that I had something interesting to think about - and can't remember the damned thing! Quite frustrating! Sure this happens to everyone. But constantly? The only way to avoid this is for me to hyperfocus (or engage in perseverative hyper-concentration).

But something interesting has been taking place recently. And I suspect it is due to the effects of the Strattera, and to a lesser degree, my own learning about the disorder, and new coping strategies that I am putting into place in my life. The racing thoughts I experience as I lay down at night, or simply during the day when I am in a quiet environment - the racing thoughts aren't there as much. At times there is almost a calm silence. A sensation of openness. Of alert calm. Hard to describe, but it is a wonderful sense. I am wondering if my dopaminergic and nor-adrenergic pathways are beginning to balance out, or somehow become tuned and working smoothly. Maybe that's what is happening as this selective norepinephrine reuptake inhibitor (Atomoxetine - Strattera) takes effect in my brain.

Strange to reflect on it - but now that I've had several experiences lately of this calm alertness, this alert tranquility, I realize now that all of my life has been spent fighting against the rushing of thoughts and of both mental hyperactivity and impulsivity. What a drag that has been. What a darned drag (I am trying to remain family friendly, but substitute any adjective you'd like). Sad in a way, I feel bad for that guy who was me, all that time, never knowing that it wasn't normal to be fighting this. I always put it down to just being a nervous or insecure guy.

Anyway, I'm feeling good about this. Now I am trying to put into place more scheduled and early bedtimes for me. I need my beauty sleep of course. I need my brain sleep.

Cheers,

Mungo

Cheers,

Mungo

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The Racing Thoughts of Adult ADHD

2010-09-22T21:45:00.009-04:00

For all of my adulthood, I have gone to bed very late. Now that I am getting some perspective on ADHD, and learning about the symptoms, and of the neuropsychological underpinnings of the disorder, I understand why. I never wanted to lay down in a quiet bed and listen to my brain revving, so I would exhaust myself until I passed out. Or in the past I would have a few (or more) drinks. That would dull the cavalcade of mental imagery.

Imagine you've got a nice vintage Mustang car. You've got it in your driveway. Your friend drops by and asks if he can sit in the driver's seat and turn on the ignition to hear the classic engine. You answer "yes, go ahead". He smiles, turns the ignition over and then jams his foot down on the pedal and the engine races out of control, your eyes bug out and you feel out of control. That's what it can be like with ADHD.

I think fast. I talk fast. I read fast. People have always commented on the fact that I can read a page of text about 10 times faster than Superman. But this isn't like bipolar disorder where there can be an unceasing pressure to spit words out, and often the utterances end in nonsense. Where the thoughts are inchoate, indecipherable jumbles of ecstatic confusion. No, this is simply because my brain runs very fast, and I either talk quickly or think quickly.

If I can match my thinking and actions with my environment, then I feel in sync and I feel okay - assuming I am filling my environment with activity and excitement (TV channel surfing, internet surfing, multi-tasking, talking, reading several books at once, engaging in several hobbies, bungie-jumping, sky-diving - you name it). But turn down the tempo on my environment and then I become uncomfortably conscious of the tempo of my thoughts, the racing, the sensation that I cannot control the speed of my thoughts.

So I don't go to bed until I'm worn out. I can be by myself for hours, but I have to be reading or doing something. I can go backcountry solo camping, but there I'm always exploring the woods, or collecting firewood, or cooking, or taking photographs. Alone with my thoughts, yes, but always matching the tempo of my internal world with the tempo of my external world so as not to get overwhelmed.

I described the train of thoughts in my head to the psychiatrist in my assessment back in April/May like that of a a lumberjack who is racing to remain upright on rotating logs in a river. You have to keep running lest you tumble into the water and get crushed by the massive logs. It is beyond your control and it feels threatening.

As I was falling asleep (or at least trying to) a couple of weeks ago, I came up with a new metaphor. I imagine that my mind is like a large boiling pot of soup with chunks of vegetables and chicken and such in it. Each item that boils to the top is a thought, quickly to be replaced by another totally different one - over and over and over. And it takes ages for it to slow down so that I can sleep.

I am now able to describe accurately a mental experience I've had for years: I'll be thinking (either as I'm laying in bed, or just generally during the day), and have an intriguing, or useful thought, and then all of a sudden it will be displaced by another thought - and I'm only left with the sense that I had something interesting to think about - and can't remember the damned thing! Quite frustrating! Sure this happens to everyone. But constantly? I think not.

But something interesting has been taking place recently. And I suspect it is due to the effects of the Strattera, and to a lesser degree, my own learning about the disorder, and new coping strategies that I am putting into place in my life. The racing thoughts I experience as I lay down at night, or simply during the day when I am in a quiet environment - the racing thoughts aren't there as much. At times there is almost a calm silence. A sensation of openness. Of alert calmness. Hard to describe, but it is a wonderful nascent sense. I am wondering if my dopaminergic and nor-adrenergic pathways are beginning to balance out, somehow becoming tuned and working smoothly. Maybe that's what is happening as this selective norepinephrine reuptake inhibitor (Atomoxetine - Strattera) takes effect in my brain.

Strange to reflect on it - but now that I've had several experiences lately of this calm alertness, this alert tranquility, I realize now that all of my life has been spent fighting against the rushing of thoughts and of both mental hyperactivity and impulsivity. What a drag that has been. What a darned drag (I am trying to remain family friendly, but substitute any adjective you'd like). Sad in a way, I feel bad for that guy who was me, all that time, never knowing that it wasn't normal to be fighting this. I always put it down to just being a nervous or insecure guy.

Anyway, I'm feeling good about this. Now I am trying to put into place more scheduled and early bedtimes for me. I need my beauty sleep of course. I need my brain sleep.

Cheers,

Mungo

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You can also follow my tweets at Twitter.com/MungosADHD

Titrated up to 50 mg of Strattera & an Adult ADHD / Russell Barkley Video

2010-09-17T13:46:00.006-04:00

I went to my doctor this week and he seems to be responding to me in a more effective manner than the previous two visits that I'd had with him. I too was responding differently - not saying much, as I'd had a rough day at work and was feeling a bit sorry for myself.

But my doctor sounded very positive about my progress and asked if I would like to be titrated up from 40 mg of Strattera daily to 50 mg, or "half way to the maximum dose we can consider". I said that I would like that, but would listen to his advice on the matter. I guess I wanted to give him a chance to present his opinion. Plus the fact that he had the ADHD clinic's notes clutched carefully in his hands (suggesting that he had read them and wanted me to know that) made me think he would have some insight.

So he said "Yes, let's do it." And so today I am on 50 mg of Strattera. I drank a litre of water during a meeting this morning. My mistake. One of the key stakeholders is notorious for talking on and on - he just might be distantly related to Fidel Castro. But the water seemed to allay any dry mouth symptoms and so far I've not felt nauseous or anything.

I am pleased with how things are going for me. Work is a bit odd, our company was bought last week (subject to a government body approval) outright, and so we all wonder what sort of redundancies and layoffs might occur... but I'm darned employable, and all the more now that I have the knowledge of my diagnosis and coping skills around Adult ADHD.

When you have some time, have a look at this great Russell Barkley video about ADHD:

Hope you all have a great weekend,

Cheers,

Mungo

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The Hunt: Harvesting, Cooking and Eating a Giant Puffball (Calvatia gigantea) Mushroom

2010-09-15T09:39:00.003-04:00

Okay, here's another nature related post. The only thing it has to do with ADHD is that getting out into nature seems to really calm my ADHD brain and restore me for a few days... Has anyone else noticed this effect of getting out into nature?

The other day I went on a hunt in a local conservation area. I harvested, cooked and ate some of a Giant Puffball Calvatia gigantea. These are choice mushrooms, and considered highly edible when still white and firm.

Giant Puffball, with characteristically cratered surface.

This Giant Puffball shows the characteristically cratered surface, along with an almost bi-lobed body.

I pulled a Giant Puffball out of the ground, and you can see the very small 'root' that provides nutrition to it. This was about as thick as a graphite pencil.

Carrying the Giant Puffball was surprisingly tricky. I didn't want to dent it, and at the same time, the weight of it began to make my arm sore. I mean, it wasn't probably more than 5 pounds, but it was bulky.

I put it on the cutting board, took out the frying pan and stared at the rounded beast before me for a few moments.

I started by removing the base. You can see the base interior beginning to turn brown - the eventual state of this Giant Puffball is a big powdery, dry, dark brown crusty ball, emitting spores into the wind as it crumbles into pieces.

I pared away some of the skin and harvested out the white, firm flesh.

Here is a closeup of the marshmallow-like texture. It was cool to the touch, because of the moisture contained within the tissue.

I skinned the beast.

I cut it up into bread slice thickness.

I noticed quickly that I had way too much to consume by myself, and ended up giving some to my neighbour.

I dredged it in flour, salt and black pepper.

I shook off the dredging powder and laid the pieces aside. I was wondering what it would taste like, but soldiered on.

Soon a rich scent filled the kitchen - and the mushroom began to resemble chicken strips.

It smelled glorious. It didn't smell like normal button mushrooms, more like - well, more like chicken and zucchini.

Into the frying pan, I put a little bit of olive oil, and butter. Once it was hot, I laid the strips of the Giant Puffball onto the pan. It sizzled.

I put it onto a plate, and gobbled it all down. It was amazing. I am going to do this again soon, and highly recommend that every single person reading this post, who lives near Giant Puffball mushrooms, immediately go out, harvest, cook and eat some.

Cheers,

Mungo

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A Lunchtime Walk on the Path - Soothing Nature

2010-09-14T21:22:00.003-04:00

I find when I get anxious at work, or when it gets a little too much, I like to go for a walk on the path around the campus - it is a 1-mile pathway through some nice undergrowth, and wild areas in the north of Toronto. I noticed today after about 20 minutes, I felt calmer and my thoughts were much smoother, and less scattered and rushing. Nature works for my ADHD!

Here are some pictures that I took:

Bracket Fungus - Polypore.

Unknown Gilled Mushroom.

Wild Grapes - tart and tangy.

Poison Hemlock.

Socrates was executed by being made to drink a potion of poison hemlock.

"Socrates' death is described at the end of Plato's Phaedo. Socrates turned down the pleas of Crito to attempt an escape from prison. After drinking the poison, he was instructed to walk around until his legs felt numb. After he lay down, the man who administered the poison pinched his foot. Socrates could no longer feel his legs. The numbness slowly crept up his body until it reached his heart. Shortly before his death, Socrates speaks his last words to Crito: "Crito, we owe a rooster to Asclepius. Please, don't forget to pay the debt." Asclepius was the Greek god for curing illness, and it is likely Socrates' last words meant that death is the cure—and freedom, of the soul from the body. Additionally, in Why Socrates Died: Dispelling the Myths, Robin Waterfield adds another interpretation of Socrates' last words. He suggests that Socrates was a voluntary scapegoat; his death was the purifying remedy for Athens’ misfortunes. In this view, the token of appreciation for Asclepius would represent a cure for the ailments of Athens."

Poison Hemlock

Aster.

Unknown Berry.

Unknown Berry.

Slightly Out Of Focus Grasshopper.

Immature Dryad's Saddle - very tasty and edible at this stage, or so I have read.

Oyster Mushrooms - Think I'll take some and have them for dinner sometime this week!

Artist's Conk - You can use a twig to gently draw on the white underside of this polypore, and it looks like you have drawn on it with a graphite pencil. Natives of North America made quite an art-form of this, and you can find many current examples for sale on the web.

Artist's Conk.

Artist's Conk.

Oyster Mushrooms.

Oyster Mushrooms.

Oyster Mushrooms.

Unknown - possibly partially decayed Dryad's Saddle.

Oyster Mushrooms.

Common Inkcap - I've posted about this in greater detail before.

Common Inkcap.

Snail Shell.

Cattail Reeds (Typha latifolia) - Fenlander has made Cattail pollen bread.

Cattail Reeds (Typha latifolia) - Owen has made cattail mats.

Cattail Reeds (Typha latifolia) - Make a Cattail duck toy, and look at Jon's nice Cattail woven mats.

Unknown gilled mushroom, growing in pine litter.

Forget the name of this wonderful looking fungus.

Unknown, amazing colouring, firm, growing on dead wood.

Will try to find out what this is - such a nice looking fungus.

I had a great walk, looking forward to what the rest of September and the coming Autumn brings...

Cheers,

Mungo

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