Tuesday, June 5, 2012


I've noticed a recent surge in my post about having ADD, and therefore think / wonder if there is an interest there.

It is tough and frustrating sometimes to think / write / talk about my ADD because I don't want to define myself by it, and I don't *want* it to limit me.  When I first found out I read (parts of) books about ADD and also about diagnoses as adults.  I say "parts of" because the reality is that I have never been able to read a complete non-fiction book, unless it was written in a story-like format. 

They talk about the denial.  The struggle because there are simple things that we think we should be able to do and yet can't seem to do.  The frustrations that we feel.  And, at some level, the relief we feel at knowing that there's a reason for this.  As I wrote in my earlier post, there were plenty of teachers who realized that I was living up to my full potential.  But none of them seemed to have the answer as to how I could do it.  I'm not sure I have it now.

There are many ways in which people can live with and manage ADD.  Pharmaceutical is certainly a popular method, and it has it's place.  But there are behavioral therapies, lifestyle choices, and other means of managing ADD.  In conjunction with meds or without meds. 

Some of the behavioral therapies, however, are hard to implement without some one else there to help you.  They are effective, or can be effective, with kids who have parents and teachers to help administer them, and work with them.  As an adult, and in this case at the moment a single adult, it is harder to implement effectively behavioral modification. 

Structure, frankly, is the most effective manner of addressing ADD.  Developing habits and routines helps keep an ADD person on course.  I do consciously try to form habits, and I could name five or six that I have developed in the past year.  But it is easier to do with someone else. 

Medication works but also has its limitations.  Essentially in order to "calm down" a hyper-active person with ADD you actually give them stimulants, and it has the reverse reaction than it would for someone without ADD.  It stimulates some part of the brain that allows you to focus.  Ritalin is the most prescribed drug, and is usually where a doctor will start when he or she begins prescribing medicine.  Ritalin, by itself, is one of the stupidest drugs for someone with ADD because it has an effectiveness of about four hours, and you need to take the next pill before the first one wears off.  But you have ADD, so you forget to take the second pill until it's too late.  As a kid, nurses used to be able to administer drugs to kids - and kids could go at lunch time to the nurse for their medicine.  These days, however, a nurse can barely put on a band-aid without having to get a waiver signed by the parents, and my understanding, in all seriousness, is that they aren't even able to administer basic pain medicines like aspirin anymore.  Parents are called if anything needs to be administered and the kids have to be picked up.

This was never an issue for me, because I was diagnosed as an adult.  But at least a routine for a kid, where after third or fourth period, they go to the nurse every day, Ritalin could work.  Except, of course, for the problem above.

The good news is the next drug they may try you on is Concerta.  Time-release Ritalin that you only have to take once a day. NOW you're beginning to get it.  That works.  So, you try a dose and stick with it for a period of time, and then try to determine whether it's effective.  This is a very subjective determination, and it gets ultimately, to be a lot like going to an optometrist and looking through the various lenses for glasses - "is this better? or this one?" when they both look the same to you.  Having a partner - as I did at the time - available to help evaluate your response to the drug is helpful.  And so you experiment with dosages. 

The trouble is even when you find a dosage that works, you eventually get used to it, and its effectiveness begins to taper.  So, then they try you on a different drug, and you, once again, go through the steps to try and find the right dosage, etc.  It can, I imagine, be an endless cycle. 

Which is why I do think it is important to address ADD with more than just medicine. 

In my last post about ADD, I talked about the Sisyphean task of pushing the boulder up the hill.  And the insanity of doing the same thing over and over and expecting different results.  Some people find paths in their life where their ADD might be an asset, or at least where their ADD is less of an impairment.  One friend of mine is a doctor, and rather than be in a routine boring family practice, the activity of the ER is much more manageable for her.  While being a doctor is a crazy idea for me, I can see as someone who constantly needs deadlines to get anything done that the fast paced rush of the ER could provide that level of "stress" necessary to get things done.

I wish I had THE answer.  I am still struggling with finding THE answer.  It is a daily battle, and it is hard.  And it makes being in relationships difficult, because it is hard for someone to understand why you just can't seem to do something.  Or you can't do it without x, y or z to stimulate you or make you do it.  It is important to educate your partners about what it is you need.  Not to make excuses, but to find a productive way to work together, and to make the relationship feel like a partnership, and not where one always feels like they have to push you to do anything.  It is doable.  But it is hard, too.

No lovely answers or concluding pearls on this one.  It just is what it is...  Feel free to add your own concluding pearls or advice. 

If you like this, stick around and read other entries.  Hit a few on the right that are favorites, or go to the home page of the blog, and read from beginning to end.  Take a moment to send me some feedback.  Thanks for coming.  Please come back soon.

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