Deficit Reduction

There’s something wrong with my brain … again. I’m starting to suspect that none of my neurotransmitters are doing what they are supposed to. This time, it’s a little more subtle. When you try to poison yourself, people always assume you have depression. When you steal tiny objects, the call you a kleptomaniac. When you vigorously rub up against people, you get arrested for frotteurism. But when you just float around like a turd in the ether, it could be something even worse. No, I don’t have a brain cloud. I have attention deficit disorder.

ADD is one of those diagnoses that annoys just about everyone. It’s overdiagnosed and oversimplified, which means it’s discredited. In kids, ADD is bad parenting, too much sugar, and a lack of direction. In teens, ADD is rebelliousness, too much caffeine, and a lack of direction. In adults, ADD is irresponsibility, too much alcohol, and a lack of direction. All it takes to fix ADD is a good spanking and plenty of criticism.

If you ever read a list of ADD symptoms, you’ll find that a lot of them apply to almost everyone. Who can say that they are always organized, pay attention to absolutely everything, and never get impatient? Lots of people lose things. Everyone fidgets in boring situations. Daydreaming is perfectly normal.

Like lots of other people, I think most of those statements make sense. I had the common misconception that ADD occurs in hyperactive boys who are have no interest in learning and lack discipline. It’s an easy stereotype, because those are often the times when ADD is diagnosed, right? Actually, even though ADD is often diagnosed in hyperactive kids (usually boys), it is just as common in kids who are not hyperactive, and most sufferers are fairly intelligent. And yes, it occurs in adults, too.

ADD is actually called Attention Deficit Hyperactivity Disorder, predominantly inattentive. There is also ADHD, predominantly hyperactive-impulsive, and ADHD combined. Historically, the disorder was known as hyperactivity (of course), and minimal brain dysfunction (seriously). Now, I never would have thought I suffered from any of those, but I’ve started to believe otherwise.

It’s hard to think of myself as having ADD for a few reasons. First of all, I never struggled in school. By that, I mean I never struggled with my studies. I was able to pass most classes without too much trouble, especially math classes. I never acted out, although I was known for not showing my work in math (it was always obvious). Second, I never had trouble reading. I spent a large portion of my childhood reading books. Many people with ADD can’t focus on one thing for that amount of time, although there are exceptions. Finally, I have a bunch of other mental issues. Attention deficit disorder is yet another log on the burning pile in my brain, which so far includes social anxiety and bipolar depression. I also have a facial tic.

Earlier this year, a friend mentioned that I might suffer from ADD. I thought briefly about it, but decided not to look into it, because I was so busy. I thought that my problems with focus and completing things were just part of that. Once I reached the end of the summer, I was no longer teaching or traveling to weddings, and I had the same problems. When I ran out of practical things to blame, I looked back into ADD. I bought a book (“Driven to Distraction”), I went over the list of symptoms with my therapist, and I came to the conclusion that this was worth looking into.

In retrospect, I can see several signs that I have ADD. I always enjoyed puzzles, but I also had to be doing something else at the same time. I would watch movies while playing computer or video games. In class, I would do puzzles or read, although I would take notes occasionally. I often said that doing puzzles in class helped me pay attention, despite the fact that it would seem to do the opposite. I have learned a lot about coping, but that can only take me so far.

After discussing the matter with my psychiatrist, I began taking Ritalin. I hoped that medication would improve my ability to focus when I study or write, among other things. Because I am already on 3 psychiatric medications, I had to start at a low dose and see how things went before making any increases. I started at 5mg daily, which is the lowest dose, and moved up to 5mg twice a day, which is still a fairly low dose. In addition to prescribing the medication, my psychiatrist instructed me to get my blood pressure checked every week.

I have been on Ritalin for about 5 weeks. I haven’t noticed much of a change, although I suppose there might be a little improvement. Anyway, I have gotten my blood pressure checked regularly. This week, there was a marked increase, from 122/82 to 138/84. I’m seeing my psychiatrist tomorrow to discuss whether or not I will continue the Ritalin at an increased dose, but I doubt that I will. I will probably have to start a new medication at a very low dose. Although it feels weird to be tired of symptoms I hadn’t exactly identified two months ago, I’m eager to see some improvement.

Fortunately, my ADD diagnosis has done one thing for me: it has given me hope. Funnily enough, the thing I want to pursue most right now is creativity, by working with writing and eventually, visual media (I hope). Unlike depression, medication for ADD is more effective and usually works much more quickly. Even if I have to start a new medication from square effin’ one, I will still be able to monitor my ability to focus, and things could improve in no time. I’ll report back on my progress … unless I get distracted.

One thought on “Deficit Reduction

  1. Hi Stephen,

    I like what you said about how ADD annoys “just about everyone”. That captures it perfectly. Even though I have been taking drugs for ADHD for the past 3 years, and have improved significantly in that time, it annoys me and I still hide my diagnosis from almost everyone, especially at work, because I’m worried they will judge me.

    Because medicating children has received so much press attention, and because the symptoms, as you say, “apply to almost everyone”, the illness is unique in that most people have somehow established an opinion about whether it’s a “real” illness. This is further complicated by the fact that adderall is a controlled substance. Even at the pharmacy I wonder if the staff is judging me as just another white-collar junky chasing whatever high I can have prescribed to me.

    But I suppose there’s not much to be done. Perhaps it will always be awkward to controlled narcotics/stimulants from another person, just as it is to buy condoms.

    Oh, and a note about dosage: I usually take 20mg of adderall XR once per day, which lasts about 8 hours. Alternatively, I can take 10mg of normal adderall once in the morning and again 4 hours later, which has a similar effect. One thing I’ve noticed is that my response is very dependent on food and drink. If I have just eaten, the effect of adderall is significantly lessened, especially if I drank orange juice. Taking adderall without food, however, heightens the effect. I’ve read antacids also increase the effect, but have not confirmed.

    Anywho, I’m glad you’re hopeful about all of this. Getting diagnosed and prescribed proper drugs for ADHD always seems to be a bit of a rollercoaster of hope and then extremely delayed gratification, so I hope you are able to find something that works for you.

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