ADHD Medication: Things to Consider

Since I write a blog that's largely concerned with natural coping mechanisms for ADD you, might think I'm opposed to medication. I'm not, actually, but I do have some pretty strong feelings on the subject nonetheless. I thought I should write a post to clarify, and to use as a point of reference, later.

In truth, I believe that medication can be a very fine thing and an important part of many people's coping and recovery. I myself took two kinds of medication at different points in my teenage and young adult years; Ritalin for a couple years in high school and Strattera for a couple years in college. In addition to the extra boost of help these drugs gave me during critical times in my life, they taught me an important lesson about the differences between my brain and those of most people and what it could feel like to live with less disability. A lot of the positive effects of these drugs became permanent as I strove to achieve the same level of performance without them that I had with them.

Coping With Procrastrination

As a follow-up to my earlier post about the causes of procrastination, I'd like to talk a little bit about some effective coping mechanisms I've discovered. Lately, I've found it immeasurably useful to deal with procrastination by dissecting it. In order to do this, I ask the following questions:

1. What am I avoiding right now?

The first question is usually pretty easy to answer; when you're avoiding something, it's usually on your mind, poking constantly at the back of your thoughts and causing you stress. Sometimes, however, that stress can be great enough that you simply can't make yourself think about it enough to address the avoidance. For this reason, it's a good idea to attempt this exercise at a time when you're feeling relaxed or happy. Also, I find it very effective to sit down and make a list of the things I'm avoiding and worrying about; getting them out of my head and onto paper transforms them from a stress-inducing spectre into something manageable.

A Completely Pointless, Unnecessary and Peevish Post

Dear ADD community:

ENOUGH ALREADY WITH ALL THE ADD PUNS!

C'mon...pleeeaaaase?

Sincerely,

Laurel

Willpower and the ADHD Brain

If you're reading this blog and you don't have ADD, I'd like to ask you to do a little mental exercise with me.

Think back to when you were five years old and your parents told you to put your toys away after you finished playing with them. Remember the resistance you felt to this activity, how spirit-crushing it seemed to do this chore when you wanted to move on to some other fun activity, like playing outside. Remember the effort it took to accomplish this task, if you could even do it on your own (which you probably could not).

Now...think about that same task now, and how it would look to you as an adult. Why, it's only probably six or eight toys that just need to be placed in a bin or on a shelf. That's no trouble at all. You can do it in about 30 seconds without a second thought. You may even find it pleasurable as you're spurred on by thoughts of how nice the clean floor will look and how useful it is to have things organized. Think that's emotional maturity?

WRONG: your brain has changed! Where you were once a creature of impulse, you now have higher brain functions that numb out those childhood feelings of resistance AND give you rewards (dopamine, I think?) for carrying out the tasks that your executive functions set forth. What was once a great feat of willpower is now a very easy thing indeed.

For the ADD brain, however, this change does not take place, or it does not happen to the extent that it should. But because most people don't understand the neurology of childhood brain development, we don't experience an overabundance of sympathy and understanding in response to this limitation. Instead, we get lectured and shamed and blamed and goaded and most of all, told we need to "try harder." We deeply internalize these messages about our own inadequacy. For those of us who never get a diagnosis, we never examine them. Even for those of us that do, the guilt mechanisms are already well in place and are constantly reinforced throughout life.

If there's one thing I'd like to communicate to anyone who ever reads my blog, it's that ADD is a genuine disability. It's as real as any physical limitation, however much it may not be visible. Though it's important for all people with neurological disabilities and differences to advocate for themselves, I believe it's especially crucial for those whose disabilities are, themselves, exacerbated by the guilt and shame of being blamed for our troubles and/or not taken seriously.

So please, my friends...always remember that compared to what it's like for us? Your toys pick themselves up.

Fostering Healthy Romantic Relationships

This is an article I wrote a couple years ago about fostering healthy relationships with someone who's got ADD. I've had a few people tell me that they've found it helpful, so I've decided to re-post here. This is a list of tips and tricks for non-ADHD partners. I intend, at some point, to write a follow-up list of tips and tricks for the ADHD partners.

Know how their brain works. The first and most important thing you, as a non-ADD partner (NAP) need to understand about your ADD loved one (ALO), is that her brain works differently than yours, because it's lacking a lot of electrical signals necessary to behave as responsibly as she'd like to. Therefore, a lot of assumptions that you might make about the motivations behind her actions aren't necessarily going to be accurate.

For example, it's quite common for an ALO to forget that she's supposed to meet her NAP at a certain time for a date, only to get caught up doing something else and lose track of time. The NAP will often assume that this means the ALO didn't care enough to make the appointment, but in truth, this is almost never the case. In general, it's easy for NAPs to assume that ALOs just "aren't trying hard enough," but usually, we're trying as hard as we can.

Expect apologies, but accept them. If your feelings have been hurt, or if you've been inconvenienced in some other way by your ALO's ADD-related behavior, you should expect an apology from her - after all, she needs to learn to take responsibility for her symptoms, even if they aren't her "fault." But if she gives you a genuine apology, accept it.

Expect improvement, not perfection. Many NAPs will get frustrated with a certain behavior in their ALO, and expect that telling her once should be enough to solve the problem completely, and that if it isn't, she didn't get the message. This is not the case - changing our behaviors takes a great deal of time and effort, so if you see any steady improvement at all, even very small improvement, you can be certain that your ALO is doing her absolute best to do what's fair to you.

Positive reinforcement is nearly always better. Because we are driven so strongly be our emotions, people with ADD are often extremely sensitive to criticism. Moreover, the negative feelings we associate with that criticism will often cause us to avoid the problem in question and thus, to avoid solving it.

On the other hand, positive reinforcement has the opposite effect - if we're complimented on our improvement, we will want to continue facing down the problem and improving. Despite how it may seem at times, it's actually quite important to us to please our loved ones.

Know the right way to express your disappointment. Sometimes, you have a right to get upset, but always remember that any harsh words or raised voices are going to have twice the effect on your ALO that they would on anyone else. For this reason, choose your reaction and your words very carefully.

I recommend that you avoid speaking out of anger, ever. When you're feeling angry, the best place for you to be is far away from your ALO. Vent to a friend, punch a wall, engage in some primal scream therapy and say all the angry and hurtful things somewhere where she won't hear them. Then, once you are able, return to her and be honest about your feelings. There's a big, big difference between calmly saying, "This made me very angry today, enough that I was screaming insulting things about you," and actually screaming those insulting things at her, and the former will make her understand your feelings and the importance of taking them seriously without doing irreversible damage.

Remember that the good and bad are connected. For whatever reason, people with ADD often share many extremely positive qualities such as creativity, charm, and a kind, generous character. Chances are, these are some of the things that made you fall in love with your ALO in the first place. Whenever you feel frustrated with one of the difficult aspects of her ADD, remember that the good things about her are there are for the same reason that many of the bad ones are.

Never forget to take your turn. As the NAP, chances are that you will often feel that you're "taking care" of your partner, in much the same way that partners of people with physical disabilities do. Always be proud of yourself for this, and for the fact that you love your ALO enough to have patience and to help her get a handle on her issues for both of your sakes.

But also, don't forget that your ALO has a responsibility to you. Tell her how it's important that she take care of you sometimes, teach her how to do this, and don't be afraid to tell her when you need this kind of treatment. She will most likely respond with enthusiasm.

Indigo Children

I'd like to take a timeout from my normal discussions of living with ADD to talk to you all about Indigo Children.

For those of you who aren't familiar, Indigo Children is (to quote Wikipedia), "...a pseudoscientific label given to children who are claimed to possess special, unusual and/or supernatural traits or abilities."

In other words, it's a New Age fad. And as it happens, it's associated with ADD. The basic idea is, ADD is a label given to children who fail to conform to expected norms because really, they are Chosen Ones. They are spiritually designated to lead humanity into a more evolved spiritual reality, and THAT's the real reason they can't conform.

*facepalms*

Okay...where do I start?

First off, I want to make it known that I'm not some dyed-in-the-wool skeptic or anti-spiritual. Far from it; I'm a pretty highly spiritual person, and it wouldn't even be entirely inaccurate to call me New Age-y (though I prefer labels like "Pagan," "ecclectic" or "shamanistic"). However, whatever I might believe about the spiritual realities of the universe, I believe that it's important to keep yourself grounded in worldly realities. I'm not opposed to making mundane, real-life decisions based on spiritual consideration, but you have to take everything with a grain of salt and question it...especially your own conclusions.

This is all especially important when it comes to the ways in which you expose your children to spiritual realities. Kids rely on their parents to form a healthy understanding of the reality around them. Without proper guidance, they won't understand the difference between the statement, "There's a president who lives in the White House," and "There are angels who live in Heaven."

So what's a poor child to do when her mother tells her she's a savior of humanity? Believe it, of course.

This problem becomes all the more serious when you take into account the new connections being made between stressed or dysfunctional households and occurrences of ADD. ADD children are desperate for attention and approval, and they live in severe fear that their parents' love comes to them only upon conditional terms. Because of this, they alternately bend over backwards to please their parents, then rebel against them to test them.

So..."Indigo" parents? Here's something I can promise you: if your child seems to enjoy the idea that he is one of the most vitally important people in the universe, it is only because he hopes this will make him good enough to be vitally important to you.

I mean...talk about sending a message of conditional love.

What's perhaps the most sad about this phenomenon is how easy it is to see what makes it happen. You see, if you spend as much time as I do learning about New Age/Pagan/occult/shamanic traditions, you encounter a lot of people with spiritual delusions. You learn pretty quickly that the more more grandiose the fantasy, the more intense the insecurity the person is trying to cope with. Given the amount of unfair scrutiny, blame and ignorant assumptions that get launched at the parents of ADD kids, it's not hard to see why some of them would jump at the chance to see their child in this "improved" light.

This is certainly foolishness, but I think the real blame for this phenomenon falls on the shoulders of the spiritual charlatans who profit from this nonsense. They are, in essence, profiting from pain.

Shiny thing!

Here's a shiny thing to look at: the essay/cartoon, "This Is Why I'll Never Be An Adult" by Allie Brosh. You'll laugh yourself silly. Allie makes her living as a blogger/humorist and she has ADD. She's an inspiration to me and reading her stuff is a real treat. A lot of what she writes is a poignant and accurate (if completely freakin' hilarious) representation of what it's like to live inside an ADD mind. Enjoy!

Procrastination

Image courtesy of Daily Pictures.

The above is a somewhat famous product of that wonderful internet meme, the demotivational poster. As you can see (provided you're not reading this post months or years after the image link breaks), it reads, "Procrastination: Hard work often pays off after time, but laziness always pays off now."

There is, of course, quite a lot of obvious truth in that cynical statement. Still, most of us learn at a young age that what is best for the present moment is not always what is best for the future moment, and that future moments have a nasty habit of turning into new present moments. We also learn that many of those new present moments can, with the help of hard work we've done in the past, yield some very excellent results that don't come of seeking quick rewards. So we figure out how to forego instant gratification for the sake of the sake of long-term security in our lives and the pursuit of complex ambitions with big and/or sustained payoffs.

For those of us with ADD, however, that learning process never quite seems to gel. Sure, everybody struggles with procrastination and discipline throughout their lives, but for us, these troubles are a constant, oppressive companion.

Study of neurology has, in recent years, finally started to confirm what so many of us have felt in our hearts but often never dared say; it really is harder for us. Certain areas in the prefrontal cortex of the brain never activate for us the way they do for others, areas devoted to impulse suppression that should be assisting us in overcoming our procrastination. When people say, "mind over matter," this may very well be the part of the mind they're talking about.

So we get through life as well as we can without it. Those of us that can motivate ourselves enough to be high-functioning usually do it through a complex system of guilt and self-recrimination mechanisms, fueled by the memory of childhood shaming by family and teachers. We don't have the power to overcome our impulses, so we manipulate them with negative emotion, just as adults learned to do with us in childhood. Those of us who have found some level of reprieve through medication know that something magical happens when a pill works for you; something switches on that was never there before, a part of the brain that we've always been aware should be there, but isn't.

All of this should seem to point pretty readily to the conclusion that the issue for us is a pure hiccup in neurological development, an immutable difference in our brain biology. And yet...I don't really feel like the fundamental reasons for my procrastination are all that different from those of most other people.

The language we use to talk about procrastination tends to be unquestioningly harsh and judgmental. We shame people for "laziness" and view a lack of ability to self-motivate, organize, and place the nose to the grindstone as a moral failure, a form of selfishness.

I think this is why, when ADD research comes along and seems to say, "Hey, it's not their fault, their brains don't work," it often triggers a jealous response in people. After all, why should we get a free pass when no one else does? You can often find a similar judgement response to other mental health diagnoses, or even to people with limiting physical ailments.

However, there is a potential paradigm shift occurring in our understanding of "laziness," one that takes a hard look at the simplistic, moralized view of these issues and looks at the psychological roots of procrastination.

One book I highly recommend along these lines is Jane Burka and Lenora Yuen's book, "Procrastination: Why You Do It, And What To Do About It NOW." The essential thesis of this book is that procrastination is caused by fear, sometimes deep-seated insecurities, connected to the action at hand. Fear of failure, essentially, prevents you from trying because hey, if you don't put your best effort into life (or some area of life), at least you can hang on to the idea that if you ever did really try, you'd succeed.

I honestly don't think the psychological roots of ADD procrastination are any different from that. Certainly, there is a biological component; for most people, these fears haven't catalyzed into the same severity of neurological limitations. Those prefrontal brain parts (as I've learned from Dr. Mate) actually filter and control emotional impulses, making them easier to overcome through willpower.

All this means is that if you have ADD, it's all the more important that you deal with the root emotional causes of your avoidance issues. And yet, all too often, ADHD treatment starts and ends with medication, shrugging its shoulders and pointing to the reality of altered brain chemistry as if it were an impassable obstacle.

I know from my own experience that with the right approach, you can greatly lessen the impulse to procrastinate. It's all a matter of convincing yourself that really, those short term gains aren't the best you can ever hope for.