Our story begins on April 10, 2008. I was having lunch with my friend Moe and near the end of the meal, he asked me if I had ever considered that I might have ADD, or ADHD. I was a little surprised by the question and told him it had never crossed my mind, actually. When I asked him what prompted the question, he said I just seemed to display some of the tendencies associated with the disorder and he wondered if I had ever checked into it. My sum total of knowledge on the subject was minimal at best. I always thought of ADD as being something that was mostly found in hyperactive, and annoying, kids, although I do know a few adults that have been diagnosed; it just never occurred to me that I could have it as well.
Being the obsessive person that I am, I immediately started Googling the crap out of Adult ADHD symptoms, tests and treatments. I was honestly pretty surprised to see that my test results, based only on the kinds of tests one can find on the web, suggested that I was likely to suffer from severe ADHD, and a few different types as well. Knowing that these on line tests were best treated with some skepticism, I logged into my insurance provider's site and found a local psychiatrist that specialized in diagnosing a number of disorders, including this. He's one of those pharmapsychiatrists that diagnoses and prescribes medication as opposed to practicing any ongoing therapy. That was fine by me since I am all about the immediate gratification that just doesn't come from weekly therapy sessions.
OK, so in 30 minutes this guy was able to tell me that I absolutely have this crap and that it was likely I had been suffering from it since childhood. Nobody knew what it was back then and I wasn't a hyper kid, just unable to focus on tasks and complete them. This was interpreted as laziness, lack of interest, whatever. I also had all the classics like getting into legal trouble, tendencies toward drinking and drugs, teachers that couldn't figure out why "such a smart kid" was not working anywhere near to potential and actually failing most classes in high school. I would score well above grade level on standardized tests and would even pass a lot of my classroom tests having never read the material or lifted a finger to study. I could not imagine anything more hideous than reading text or doing homework, so I never did it. I have no idea how I got away with this and still graduated high school. I do know that I NEVER would have been able to cope with college, so a lot of the resentment around not being "sent" to college was misplaced and is now just gone…almost…kinda, sorta! J
So here I am at 44 wondering what things might have been like if this were a known disorder with available treatment when I was a teen. Oh well, better late than never, right?
What follows is a daily journal of my experiences with this disorder and its treatment. I am keeping this for my own peace of mind and to report to my Dr. and to get it out there for anybody else that might be interested in hearing firsthand what this is like.
And away we go….
After leaving the cardiologist's office on Thursday with the green light on taking the Adderall, I rushed straight to the psychiatrist without even calling or making an appointment. I figured I had nothing to lose and I wanted my DRUGS!!! I walked in and explained to the receptionist that I had no appointment but that I would really like to see the Doc to get my prescription. She scolded me a little for the drop-in, but said they weren't too busy and that I could get away with it this time. After explaining the outcome from the visit to the cardiologist and showing what paperwork I had to back up my claim, I asked if we could get started right away because I had been anticipating this moment for a few weeks now. I had read tons on the disorder and the treatment options and the medication itself. I was ready. Feed me, Doc!
He was glad to write the scrip and explained that we would start with 10mg of Adderall XR to be taken in the mornings. I said that was fine, but I am starting today unless I am told absolutely not to. It was already 2PM and he said if I did that, I was in for a late night. Whatever dude! Gimme the meds!
OK, for now, the narrative portion ends here and this post will take on the form of simple, stream of consciousness journaling. I may come back later and turn it into something else, but for the time being, it is here to serve a purpose.
Day 1 - Begin the Begin
Started at 2PM, even after the warning. Just too eager to see what it is going to do to me. For me. Maybe not smart, but anxious to get going. Maybe one hour in, noticed a slight "speed" feeling. Got bearings. Sat at home with computer and organized my iTunes for my new Touch. VERY focused on this to the detriment of other things to do; plan dinner, shop, cook, WORK!, finish yard. Lots of thinking about what I was experiencing. Over analysis as usual. No change there. Just hyper-aware of being aware. Tried combining TV, but felt the need to carry on with the iTunes until finished. Kept going on that until 10:30 PM, then moved to the desk to do actual work for client I had been putting off for two days. Slammed that out and then did some emails. Again, VERY focused. Then turn that focus to porn. Oops! Had been noticing that my tactile sensations were way up. Basically horny! Hadn't expected that. There was a "cocainy" feel to the head and body, and that used to make me horny too, but it always left me unable to follow through whether alone or not. Not this stuff though. Weird! Finally went to bed around 12:30 intending to play a video I had downloaded for the aforementioned purpose, but ended up falling asleep pretty fast. Again, a weird combination of sensations with an "upper" vibe, but able to just go to sleep anyway. I think I might like this!
Day 2 – Hi Ho, Off to Work I Go
Up at six and couldn't wait to pop a pill and see how my day went. Keeping them by my bed with a bottle of water so it is the first thing I do when the alarm goes off. Moved to half-caf coffee this morning to make sure I didn't wig out on caffeine and amphetamines! Got the kids off to school and came home intending to shower and head to the office. Didn't happen! Things kicked in by 7:30 and I was off to the races. Driving home from school I was already in hyper-focus land. Got home and sat down to finish the iTunes work started the night before. I was very aware that I was able to finally really understand iTunes and how to make it work for me based on reading what was on the screen and paying attention to detail rather than just loading the music, right-clicking to get album artwork, having nothing happen and then giving up. What a concept. So much so that I wasn't able to walk away from it until about 11:00! Finally took a shower and headed out. Driving was…um…interesting. Had my new iPod Touch and found I was more focused on that than on the road and my car. NOT good! Got to work and was feeling a little speedy. First time I had to interact with adults while feeling this way. Not easy at all. Naveen knew the score, so I explained as best I could what I was dealing with. Again noticing the "buzz" and tactile aspect.
Around 1:45 I notice my foot tapping. First time I've done that since before I dropped the first pill yesterday. Once aware of that, I felt like it was "wearing off." Losing that focused feeling. Starting to wander around on my computer and in my head. Back to working many tasks and finishing none. Also noticed I was drinking LOTS of water and had little appetite. Only had a few bites of lunch throughout the day. Peeing a lot as well. All of this reminds me of the "old days" with coke or meth.
Looks like about an 8 to 10 hour ride on one pill. By 4:30 – 5:00 I'm crashing and not digging it. The drive home was in a bit of a daze. Lots of yawning and rubbing eyes. At one point I thought it felt absolutely like a meth crash and at that moment, I would have gladly accepted a pipe to get it back to where it was. That was not a happy memory. Decided that tomorrow I will change the plan to have one 10mg early morn and one at around 1PM. We'll see how that goes.
Day 3 –One Is Good, Two MUST Be Better
Up at 5:15 to finish cooking for NoM GM. Popped pill number one with glee. Couldn't wait to be in the zone. Within an hour, I was there. Cooking, drinking decaf, planning my day, remembering that it was John's birthday, remembering to pack Andy's book to take to the meeting, remembering all the stuff that needed remembering and with very little effort. The meeting was a whole new world for me like this. I was focused on what people were saying when they talked and not on the birds, the kids, the dogs. Felt like I was really participating rather than just observing. Things and people even seemed clearer visually. Met new men and remembered their names for longer than the time it took to hear them when they were introduced. Nice thing was that the feeling of being high wasn't there. Thinking maybe it is a breaking in period for the body or the brain. Three days in and the daytime feeling is seemingly stabilized.
Left the meeting at around 12:45 and popped pill number two in the car at around 1PM, so that's eight hours between. Not sure I will have that time luxury unless I get up as early as I did today all the time. If the second pill lasts into the evening and keeps me awake until midnight or later, no way will I get up at 5 – 5:30 every day and be able to function for very long. My hope was that I wouldn't get an intensified high during the expected overlap, but rather that it would just prolong the "being in the zone" into the early evening and/or beyond. So far, it worked. It's 7:40 PM and still there for the most part, although, there is a crash in the making. Will do the same again tomorrow and see what happens.
A few side notes: Noticed that I am sitting calmly in the car, not fidgeting, tapping feet or steering wheel. Not aggravated when a light turns red. Not that interested in the poor driving of others as long as they don't pose a danger to me. Not nearly as distracted by the Touch when driving. Smoking a lot, which is the opposite of what I had hoped. Will deal with that later. Started making a list today and it got way long. First it was the Quick List, then the Big List and then finally just a list. It's long and getting longer. So many things to get done. Need to learn list management, prioritization, scheduling, etc. Otherwise it will just become a massive and unattainable list and my head will explode.
Days 4, 5 & 6 – Three Days Grace?
OK, so I fell behind on the Blog journal. What a shocker! Been making lists every day and this has been on it every day, but seems to have taken the lower priority. Need to work on that not happening. Seems like there is just SO much work to do around this whole ADHD thing, like…
- Working out the meds, so far on my own, but have follow up appointment with doc tomorrow. More on the experimentation fun and games later.
- Learning anything and everything I can about the symptoms, treatments, tools for managing life, available resources and support groups, and on and on and on.
- Reading, OK listening to, the book Delivered from Distraction
by Dr. Edward Hallowell. WOW, what a book. 12 hours on iPod unabridged and almost all of it so far (I'm up to Part 3, Chapter 11 or 12 now) is fascinating, eye opening, funny, sob inducing, useful material. No idea how long it will take to finish. Been listening to only that in car and on headphones when walking (more on that later too)
- Writing in hard copy journal, mostly tracking meds dosages, times and results, making daily To Do lists, a little general journal writing, but not nearly enough. That, and this, is going to take practice and discipline, neither of which appear to be generally easy things for the ADHD brain. At least I know that now and can breathe a little easier that I am not just fucked up in the head. OK, I am, but it's not my fault or anybody else's and that makes a huge difference in self perception and self confidence.
Trying to build routines for myself. This is something not likely to be successful if I am silly enough to just try to do it myself.
- On positive note, have included a brisk 40 minute or longer walk everyday followed by a long hot shower, which is in and of itself a whole new experience. Again, more on this later. Have to finish this list first. Maybe it IS finished. Let's see.
- Nope, forgot one other not so minor thing. Have had to also incorporate actual work work into my days. Luckily not terribly busy this week, so that's helpful. I do wonder, however, what it would be like if I were busy and needed to be in the office rather than having the luxury of working from home. Traveling to new customer for kick off meeting and requirements gathering next week, so I guess we shall see. Better not mess with the meds too much during that, huh? J
Sooo, here we are back again with three days to cover. Actually, the list above covers most at a igh level, but I need to elaborate on some. Understatement? Um…YEAH!
Let's talk meds first. Doc put me on a dose of 10mg Adderall XR (Extended Release) to be taken once in the morning, but as evidenced in the above entries, that didn't really work out. If I took it at say 7:00 AM, I crashed by 3 or 4. The crash was not fun at all and pretty much ruined the rest of the day. When I got home, went straight for the bottle to medicate. Bottle of vodka I mean, not bottle of pills. NOT useful. So I took the advice of a friend and decided to alter my routine with the pills. On his learned advice, I obtained four of the Adderall 20mg IR (Immediate Release) from another ADHD brother and cut them into quarters so I had a nice supply of 5mg IR essentially. I start my day with a 5mg IR to "get going." It's a faster road to "the zone" since the IR only take about 20 minutes to hit the brain. I ride that for a few hours and then take the 10mg XR for the 6-ish hour ride. I say ride, but that feeling went away after the second or third day. Now it's just a level of awareness that the difference in mind set, attention, focus, etc. are there where they weren't before. Then around 4:00 PM or so, I take another 5mg IR to get through till bedtime without feeling like it's all going away again. That's the feeling that just sucks. It's not like coming down from a high, but rather like being given the gift of sight only to notice that things are starting to get dark again. Like knowing you better hurry up and do what needs doing before you lose the ability to keep it in your brain long enough to do something with it. I get back to that "wait, I can't remember why I came into this room" feeling. I notice that my foot is doing the tapping thing for the first time since I sat with my coffee and cigarette in the morning before the IR kicked in. I notice that I have 6 Internet Explorer windows open, all in the middle of some task or some page I was reading or form I was filling out. That I have two or more open, but unfinished, emails on the desktop. One metaphor I just thought of was that it is like going from watching a movie or show on the TV and slowly noticing that the picture-in-picture has been activated and not being able to concentrate fully on just one of them. Then the screen that displays 8 or 16 channels at once comes on and you know it's all just gone now. The ability to focus. The ability to not get easily distracted by the cat sitting at the window outside. Too late in the day to take another pill lest I resign myself to being awake until 1:00AM and waking up feeling like shit and maybe popping two pills in an effort to get there quicker. I did that once, so I know from whence I speak. It ain't the way to go! Need to talk to the doc tomorrow about the best course to get the best results given my experiences of the past week and my propensity for pushing too hard for the quick fix. Might be that Adderall isn't the best choice for me. I dunno. We'll keep you updated on that story as it develops. We now return you to your regularly scheduled programming, already in progress.
Booze and cigarettes – I remember thinking only a week ago that I couldn't wait to start the meds because then it would likely remove, or at least dampen, my smoking and drinking habits. These, along with other abuses like food or sex, are trademark behaviors of the ADHD afflicted. I believed that once magically centered and focused that my desires for my two biggest weaknesses would dissipate. Not so much! The cigarette consumption has generally increased. Now that I am in this thing, of course I remember that it's the same when ingesting other stimulants as well, be that anything from caffeine to cocaine, and everything in between. By the way, I am now 100% caffeine and sugar free and have also dropped six pounds in as many days. Some of the side effects are pretty peachy! As far as the booze, that's going to be a tough nut to crack for me. Though I have been working, kinda sorta, on it with my NoM team for a few months, it still remains for the most part unchanged. The level of drinking varies from day to day, but not by a lot. There are dangers associated with alcohol consumption and stimulants, so I need to be mindful. Actually, I am mindful, just not so much as to actually affect the necessary change. It feels like the rationalizations behind the desire to pour a drink are a little different, but I don't feel like that counts for much. Before the meds, it was a feeling of slight dread as I headed home that sparked my excitement over pouring a drink, to be followed by another, so that I could "check out" as quickly as I could. I'd pour a cocktail or glass of wine to have while I cooked dinner and that one would go pretty slowly, but then I'd pour another to have with dinner and another to have after dinner and another to take to bed. It's a hideous pattern, made even more so by the awareness that I was doing it while I was doing it. The morning after is never very pleasant either! At the point of pouring the "take it to bed" drink, I do so with an attitude, greatly aided by the alcohol already in my system, of "Yeah, whatever. Who cares?" So now it's different and yet still kind of the same. Come 4:00 or 5:00 PM, I know the effects of the Adderall will be going away soon and I want to avoid the "back to normal" feeling that's on its way. I think what we do, we being the ADHD brained population of the world, is to look for anyway we can to not be in our own heads. That's where we live. It ain't fun in there, I tell ya. What's the Pink Floyd lyric from The Wall? "I got thirteen channels of shit on the TV to choose from…choose from…choose from." That's what it is like in my head and I am reading that I am SO not alone! The only way to narrow it down to a manageable amount of shit is to alter your state, however you can. The statistics I have been hearing and reading about the number of untreated ADHD cases in prisons come as absolutely no surprise. I remember being headed down that very path. It's possible that at least one thing that saved me from it was one thing I hated my father for the most at the time; moving from place to place so much when I was a kid. Had we not left Dickson, TN when we did, I would surely have followed my friend Paul into that world. We used to get up to some really bad shit. If it was dangerous and illegal, we did it. I was thirteen, for fuck sake! Paul went on to do bigger crimes after we moved away. He landed in jail and then prison. He once grabbed his own pinky finger and snapped it, broke it, when on some medication to calm him down. He told me when I was back for a visit to my grandmother's that he did it just for a thrill and he grinned when he was telling the story. Paul died in a knife fight some time later.
Whoa, that became a bit of a tangent, huh? The sudden ability to just write and write is amazing at times. OK, what's next?
Learning new tools – From everything I am reading, it is clear that medication alone will not be the be all and end all where this new journey is concerned. It's a beginning. Just like putting a name to what makes you the way you are is a beginning. Both are HUGE beginnings, but once past the euphoria of those beginnings, the learning, or re-learning begins. I see that staying dedicated to that learning and putting it into practice is not something I will be successful at doing alone. It felt like it at first, but that's magical thinking, and that's not me; ADHD or not. I see there are a lot of tools available and just got a couple. Another audio book called Getting Things Done by David Allen and a hard copy book called ADD-Friendly Ways to Organize Your Life by Judith Kolberg. Need to finish Delivered from Distraction on the iPod before listening to the Getting Things Done book. I do have a suspicion that I should have ordered a hard copy of that one, but we'll see. Anyway, my plan is to get the meds right, understand the requirements for effectively learning new techniques and then executing on that learning. The biggest difference between this realization and so many that have come before it, is that I finally found the right starting point. I have spent years ordering books and "systems" that promised to change my life for the better as they had so many others that had ordered them and learned them and put them into practice. Late night and early morning TV is filled with these miracle products. Just order my course for 1000 easy payments of $2.99 and you too can learn the secrets that will unlock the door to your dream life. Everybody from Carlton Sheets to the dude with the suit that looks like the Riddler to Anthony Robbins to Donald Trump. They all had the answers and I ponied up to get those answers because something just wasn't working. I'm smart, but I just missed something along the way and these guys are here to help me, right? RIGHT! What is so ridiculously clear now is that nothing I tried would have ever worked, and in fact nothing I tried did. Not because I am stupid or weak or don't want to succeed, but because I couldn't! Literally, physiologically could not. I now know that when my standard answer to why I did or did not do something was "I don't know", it was because I really, truly did not know. What a revelation! What a thing to discover that this is due to a disorder and not a lack of interest or a lack of effort. Whenever I vowed to make an effort, the vow was based on true desire and the lack of ability to focus and follow through and be wildly successful like those people I saw on TV was because that just wasn't the way my brain worked, even though it was supposed to. Part of this feels like an excuse, but I know in my heart that it isn't. What I see so very clearly now is that in order to set myself up for success, it took what I am doing now. It took a medical diagnosis and a prescription and some serious research to discover that I can create the ability to focus on the necessary learning and the application of that learning to know success. With the knowledge gained in the past week, and the mere fact that I am able to have a day like I had today, a day where I woke up, took a pill, made a list, recorded my meds from the previous day, floundered for a while until my focus was sharpened, exercised willingly for 40 minutes while listening to, and absorbing the material from, an audio book on ADHD, took a 20 minute shower, successfully worked my way through my list and am now sitting here writing like a mad man, albeit with a fairly strong vodka & cranberry (all things in good time!) , this behavior and level of early success gives me the absolute faith that, as long as I dedicate myself to a very rigorous and well planned treatment program that includes therapy, meds and support, I am perfectly capable of seeing to fruition whatever goal I set for myself.
Alrighty then , I am relatively certain that the final sentence in the paragraph above would qualify as the longest run on sentence I have ever written, and I've written a few! That fact, and the clock on the wall, tells me it's time to bring this blog entry to a close. I certainly haven't covered everything that has been stirring in my head for the past three days; not even close. I will create a habit of writing shorter amounts more frequently, but it will take time to hone that skill, just like everything else. What a beautiful thing to be able to see that and to know that it will happen! I cannot even begin to tell you, dear reader, whoever you are, what a beautiful thing it is.
Another entry is promised after my Dr. visit tomorrow. Until then, be well and thrive.
Day…um…day…oh, never mind, it's all Days Gone By now!
What the crap did I say up there? An entry PROMISED after the next day's Dr. visit? That was fully two weeks ago! No way can I play catch up for a full two weeks to any level of details. Let's do highlights instead, yeah?
I know there was a week away on business. It was a good week as weeks ago. Wait, let's back up a bit. I forgot the juicy part with the Doctor appointment!
So I shared a super concentrated version of all the ramblings above with him and he just verbally bitch slapped me! Apparently the patient is not supposed to take on the task of playing around with the meds. Who knew? Seriously though, he brought up the very valid and not a little scary point that with my heart thingy (The SVT. I mentioned that, right?) increasing the dosage of stimulants I take by obtaining a few extra pills from a fellow ADDer is dangerous and could kill me! Definitely not the desired result. I left his office feeling like a scolded child, but it was deserved. Plus I got what I wanted anyway. He agreed to let me continue with the dosages I had found to be more helpful through my little experiment. All's well that ends well…right???
OK, the business trip. Really good on a daily basis until the last day. Got up every morning and walked, vigorously I might add, for 30 or 40 minutes and ate healthy all day, then another 30 minutes on the elliptical after coming back to the hotel. On top of that, I limited myself to no more than two glasses of wine with dinner at night and drank nothing more before or after that. These are seriously large changes for me. A virtual paradigm shift, I tell ya. Very, very cool and happiness inducing. Day four, however, was a bummer. I ended up getting stuck in Alexandria, LA for an extra day and night. Too long a story to regale you with here, dear reader. Suffice it to say I had only packed enough meds for the 3 day trip. NEVER AGAIN! The day started well enough and I stuck to my morning routine, meds or no meds. By the end of the day I was a bit of a wreck, though. Turned straight to alcohol to self medicate. Only one double scotch at the airport at 5:00 PM-ish, but still, just feeling the strong compulsion to do that was aggravating. Anyway, I made it through, albeit unhappily. Back on track the next day and things have been pretty good since.
Now, for the past week I have noticed a slight change, an inconsistency in my mood and performance even while sticking to the same dosages of Adderall (10mg IR at 6AM, 10mg XR at noon, 10mg IR at 5PM.) Mornings continue to be my best time for motivation and follow through; drinking decaf, working out at the gym, eating a healthy breakfast, taking my supplements and skipping off to work with a jaunty step and a smile in my heart. Afternoons take a slight detour, though. I think it's the slower, lower XR's that are doing that. I start to fidget and wander and become very distractible and unable to stick with a conversation without my head just going off somewhere less uninteresting to me. I see somebody talking at me but I hear Charlie Brown's teacher. By the time I pop the 5PM IR it's time to go have an evening and within 20 minutes or so, I am back to being switched on, not interested in TV very much, not interested in more than a glass of wine or so, just generally enjoying a productive evening and a good night's sleep. Time to research and see what new thing I can beg my doc for. I'm still pursuing long term treatment that will likely include Cognitive Behavioral Therapy, but that hasn't solidified yet. Hard to find someone close that is in my health plan and that doesn't just completely turn me off. We'll see where it all goes. What's the alternative? I've spent years seeing it all go nowhere and this is better by leaps and bounds…TRULY.
Another Day, Another set of meds to try
OK here's a new twist just for fun...
Just came from head doctor appointment and have a new regime to try. He wants me to take a 10mg IR AND a 15mg XR when I wake up, followed by another 15mg XR early afternoon. I am to do that for a few days to see how it changes the current set of inconsistencies with regard to having good motivation and follow through but still a lack of focus and concentration. What I mean by that is that my mornings are grand, what with getting up, popping a pill, having a cup o' decaf and heading off to the gym like a good little ADDer, but then finding myself unable to have a conversation without my head going off to whatever place it damn well feels like and me not having a clue what the crap my boss is saying to me!
And if that's not enough, after the 3 or 4 days, I am adding a 25mg Strattera at bedtime. Woohoo! Better living through chemicals, right? The Strattera is supposed to make up the difference where the Adderall is lacking. That would be grand…grand I tell ya. I am feeling antsy and want to start the Strattera tonight, but I said I would follow the doc's rules, and follow them I will. He's a good guy, no matter how much of a jagoff I thought he was after scolding me two weeks ago. He has my health, both mental and physical in mind. Oh yeah, ad he has that medical diploma thingy up on his wall too. I don't have one of those, so he's in charge, I guess.
Stay tuned for further developments and they..um…develop?
