Tag ADHD

“27 8×10 color photographs with circles and arrows and a paragraph on the back of each one.”

Angel Ackerman 4 Comments

I have been writing this entry in my head for about two hours now, I even opened the phone app and literally started the file– the first keystrokes on the blank screen– in between doctor appointments. I feel a bit like the main character/Arlo Gunthrie in “Alice’s Restaurant.”

Which is a reference that probably only makes sense if you’re a Boomer or GenX like me.

In that song, the Arlo Gunthrie protagonist faces criminal charges of littering and the police department has submitted into evidence for the court case “27 eight-by-ten colour glossy photographs with circles
and arrows and a paragraph on the back of each one” only to have the judge enter the courtroom with a seeing-eye dog. (Then the joke: “it was a typical case of American
blind justice, and there wasn’t nothing he could do about it”)

If you need some more explanation… Here’s the whole song.

I woke up at 5 a.m., wide awake for two reasons. 1. My brain had flipped back on. Full force. 18 thoughts at the same time. But 65 minutes of deep sleep, even though I only slept six.

I tried to go back to sleep, I really did, but I ended up clamoring to my feet. And for some reason, I got dressed. Like really dressed. Fake satin and lace skirt, sweater, dress shirt, boots. Gained five pounds because they weighed me with my boots.

My blood pressure was high because I had two doctor appointments this morning, one of which I have been concerned about for more than a week.

I left a few minutes later than I would have preferred because I stopped to do some dishes, thought I left my phone behind, then circled back because I had had my phone the whole time. I made it almost to the office when I remembered my primary care practice had moved to a new building (luckily, more or less across the street from the old building) and when I arrived in the parking lot, I realized how big the new building was. And the signage wasn’t the best.

The inside of the building on the side that wasn’t the big physical therapy office seemed dark and unfinished, with about six self-service check-in kiosks right inside the door. So I walked around the building before heading in. And turns out those walls that looked merely framed out and not finished– that was actually decorative trim. Then I found the building directory and elevator (which took forever to go one floor) only to have it open into one of those massive waiting rooms with several practices feeding into it. Yup, definitely not the homey small feel I am used to.

And by the way, if I would have turned right and gone up the stairs, the waiting room was right there.

I finally arrive and the woman who checked me in is there for the day and needs a minute to figure things out, and a familiar face comes and helps her, then we all start talking about my hair, and before I know it, my shrink-by-proxy is wandering the waiting room looking for me.

She guides me back to her office, which is no longer a closet, and she fights with the light switch to try and lower the lights. I have confirmed that she is a MSW, and I notice she has a backpack with her name on it on a hook inside the door. [hang loose here guys– I have been interrupted from this post several times and it has tense shifts and all sorts of issues that I’m not fixing.)

Now, remember my “Alice’s Restaurant” reference? I had my Book of Kells reusable canvas tote filled with about 25 pages of spreadsheet data, a copy of my legal pad to-do list, and self-report ADHD surveys filled out blindly by Eva and I. As soon as I sat down, my MSW-shrink-by-proxy said, “I’ve talked to [primary care provider] and we believe you would benefit from an evaluation from a psychiatrist.”

Oh? The same one I wanted to see about 14 months ago?

Yes, that one.

I have been told and I knew from the beginning that the likelihood of this program helping me would be slight, and we thought it might be a way to get me further up the food chain. It did not. But that’s okay. I respected her for saying that she could not continue to experiment with medication to guess what I might tolerate and what might help.

I mentioned where my daughter receives her care for her ADHD, and my doctor’s staff made a recommendation on a physician there who might be a good fit.

So she didn’t look at my visual aids.

She sent me back into the waiting room where I intended to do my morning journaling.

A woman broke away from the medical assistant who had been sent into the waiting room to retrieve her.

“Excuse me,” she said. “I love your style. And the boots are great.”

“Thanks,” I said. “My business color is bright pink so these are my special event boots.”

“What business are you in?”

“I have a book publishing company, Parisian Phoenix.”

“I lived in Paris, and I worked in fashion for 15 years…”

Do I need to tell you that made my day?

I was about to head out to my car and grab business cards– because I had almost 45 minutes until my next appointment. But then, the medical assistant returned for me. My doctor was almost done with a patient and she thought he might get to me early. He did not.

I think she forgot it was working-with-residents day and that my doctor pretty much does everything over once the resident does it. I forgot that too. I sat in the exam room for more than 30 minutes, and then spent about 20 minutes with the resident. He opened with, “So what brings you in today?”

“I don’t know,” I answered. “Dr. Mathur has some concerns about my bloodwork and asked me to come in– I believe it was because of my low vitamin D and increasing A1C, but if you poke around in my chart, we can talk about anything you like.”

Short version: He wants me to watch my consumption of sugars/carbs, take vit. D and B12, and exercise. And he gave me all the standard advice. He asked if he could give me an exam. I said sure. He listened to my heart, looked at my knees (not sure why) and then gave me a neuro exam. Which I recognize at this point as I see a neurologist 1-2 times a year.

“Let’s see if you do this better than my neurologist did yesterday,” I said.

And he almost laughed.

He then left to “talk to Dr. [my doc]” and I didn’t see him again for more than 30 minutes. He returned with my doctor and suddenly my doctor and I are talking about veganism, my service dog, the macaroni and cheese at Chick-Fil-A, and the pizza at Spice Crust Pizzeria.

The resident smiles.

I explain to my doctor that it’s the Indian fusion pizzeria down the street. “They use what looks to be high-quality ingredients,” I add. “I bet he’ll agree.”

I gesture to the resident.

“It’s good,” he confirms.

Apparently, the resident is a “smart one,” according to my doctor, and he’s authored papers on vitamin deficiencies.

“You didn’t tell me that,” I said to the young doctor. I swear, he practically blushed.

Then we talked briefly of the medication debacle (Zoloft), and I told him why I had pursued this and the emotional regulation I experienced on Adderall.

But no one looked at my materials…

When I got home, I called the recommended psych practice and they require a good old paper referral. So once my doctor’s office faxes them that, I will get a call from them.

Over-firing

Angel Ackerman 3 Comments

I saw my neurologist/physiatrist yesterday. She’s a fabulous doctor and a dog lover. So at the end of my visit, I showed her the video of me working with South. She watched most of the video, paying attention to both of us.

She’s really excited and hopeful about the potential service dog placement.

She’s concerned about the recent changes in my movement and issues with my left leg and has recommended physical therapy, which I will do if I can do it before my deductible resets. I did, after all, hit my deductible for the second time this year.

She is okay with me taking up to 20 mg of baclofen 3-4 times a day. But she warned that experimenting with other medications for my mental health may impact my spasticity. Especially stimulants. I told her, anecdotally, the stimulants settle my brain enough that I don’t feel like I’m fighting my body all day. She expressed her doubt with a twist of her lips.

I understand the need for guidelines and best practices and the only value diagnoses often have is to put a label on something to render it necessary so insurance will pay for it. I am low on Vitamin D and have a history of anemia– I take iron fairly regularly so my ferritin is okay. My doctor followed-up with some vitamin B12 tests to make sure I don’t have an issue there– those were deemed medically unnecessary and I had to pay $500. As a small business owner who works several part-time jobs, that’s a significant amount of money to me.

There are so many things about trying to find relief for what bothers a person…And yes that sentence is deliberately ambiguous.

My daughter walked into the same office I am visiting today, at age 17, as one of her first visits to an adult family medicine practice. She asked for an ADHD diagnosis and medication and got a base dose of Adderall with no issue. Now, let me reiterate, that a true diagnoses of ADHD requires manifestation in childhood– and parent recollection counts. In my case, I have no such thing. My mother would probably shrug. My dad is dead. My biological father is also dead, and my mental health therapist thinks the ADHD comes from him. My grades were impeccable. I loved school. I talked a lot. ADHD was not a thing back then. I did not have a traditional doctor or routine medical care from around age 5 to 20.

My daughter, while her upbringing was much different, had an old school pediatrician who had patients my age. So emphasis on old. But he was good, and his office was about 400 steps from our house. That’s what I liked. We only had one car. Eva did, and still does, great in school. I would wager she has more intellect and capacity for greatness than I ever did– yeah, I’m implying that my kid is smarter than me and I think I’m pretty damn smart– but she’s got this streak in her… She calculates the end result she wants and the minimum effort it takes to get there. I am an all-in, competitive personality. She talks so much I don’t think she ever has a thought that doesn’t come out of her mouth. But, unlike my upbringing, which was a typical GenX “go outside and play” and adults did not really interact with children variety, I have encouraged her to speak her mind. I learned early on it was easier to hear her out and reason with her than enact arbitrary rules. She never stops moving, unless she’s asleep. And to get her to sleep as a baby, Darrell had to swaddle her so hard she couldn’t move or else her little limbs would slap herself awake.

But no one ever asked us if we thought she had ADHD.

Looking back, it makes a lot of sense. But when she was 17, no doctor really asked us. The school never said she might have it. Eva was a great student, and, while I was the traditional “teacher’s pet,” she became the kid who looked after the kids who had behavioral issues. The teacher would sit the disruptive kids next to her so she could help keep them in line. I wanted to impress the teacher, she wanted to help. Eva has always excelled at determining what has value to her and what doesn’t matter– the kid deleted all the invitations to high school and college honor societies– whereas I always reach for whatever achievements people tell me should be next.

But yet… we are the same.

I am 51 years and 5 months old. And about one month ago, I took a dose of Adderall that changed my perspective on the world so dramatically I get tears in my eyes right now typing this. THAT is what makes this journey exciting, frustrating and dangerous. If they offered me any drug that could make my brain do the things (or not do) like that… I would take it every day and probably pay a hefty price for it. It’s not about feeling “good,” it’s a chance to live my life without feeling constantly under threat.

And I’m so sick of doctors trying to say I’m depressed. I have close friends who have clinical depression, and a few peers with bipolar depression. I don’t see any of myself in that. I’ve said it before– I love everything about who I am and my life, and I recognize the good I do, what I have achieved, and (as my mental health therapist says) the value it what I have avoided. I have survived and thrived.

But sometimes, my brain tears me apart from inside my own head.

I carefully plot my time and my schedule to do the things I need and want to do. I choose commitments based on my personal values. But no matter how much I try to avoid it, I end up overscheduled, rushed and overwhelmed, and I happily but unwisely maintain an intense work schedule until my brain just stops (despite how much I love everything I do). I work, I work, and then one day I have no energy left and it feels like the soul has been sucked out of my body. No matter what I do my brain will not turn on.

I now believe, that’s BURN-OUT not depression.

And I do this over and over and over again. I have treated it like an emotion, like something inside me is wrong, and it’s just a different kind of tired. I never understood that until now.

At the arcade, when I was playing Mario Kart with the teens, I could play the game without tension, without feeling like my life was on the line, and I got a similar “rush” whether I won or lost. I enjoyed playing. I enjoyed trying. I enjoyed the camaraderie. I had never experienced that before.

There are a few special moments in my life when I experienced intense beauty, or better than usual sex, or a new level of emotion, when the world felt quiet and peaceful and warm, and I never realized until now that those instances of being truly in the moment don’t have to be that periodic. That…

Pause. 7:15 a.m. My alarm would have gone off now if I had slept more… and here I am now, crying. Typing this.

Yesterday, my daughter resumed her Adderall after the pharmacy did not have it in stock. Between her recent ear infection and the pharmacy issue, it had been about three weeks. So she split the pill with me. (Yes, this is a tangent, but bear with me. It’s pertinent, and this is the stuff that I will organize and edit when I write these things for real.) I experience some of those calm, beautiful moments throughout the day yesterday. Laughter with my friend, Nan, as we soaked in sun walking across the Staples parking lot, for example.

I went to work at the restaurant and learned I had a four-hour shift at the work center I like least and that hurts me most. No break. Just four hours of hell. I was very stressed about this before I clocked in. I even got a high heart rate notification from my watch. But I was also oddly resigned. Like we’d see how it goes. The first half an hour I was tense, but also steady. I said to the supervisor– the young one whose very energy increases my natural anxiety– “hey, I haven’t done a full shift in this work centers in six or seven months so I’m a little flustered.” And I communicated with her that I needed more supplies, and that I may need some help keeping ahead of what needed to be done.

Someone else asked if they could give me a hand– and we had had a special event that involved having children coming to get themselves ice cream at my station during the dinner rush– so perhaps that had me on edge, because I knew I had tp be on my best behavior and keep a tidy station… So I let them help, and this is someone who has energy closer to mine, though still he has the same frenetic tendencies the supervisor does, and it was fun. Because of the camaraderie. By the end of the night, I was having a good time by myself, and when I got behind, in the same way that often felt hopeless when I was unmedicated, I was able to listen to my rational brain and let go of the anxious thoughts. And I left my shift with good energy and minimal pain.

The emotional regulation piece of this is transformative.

I have always thought my brain was a hugely unreliable narrator. That I couldn’t trust it. I didn’t know when it was worthy of my trust. I now realize I have a highly logical and organized brain, but when it’s overfiring, and that’s the best way I can describe it, the thoughts fly faster than my poor little cells can file. Yes, I’m imagining neurons with little filing cabinets, and happy brain chemicals tossing balls of happy and calm around, and my poor little office workers being clumsy athletes.

This is where I would insert a shrug emoji if I were texting someone…

TO BE CONTINUED….

The Dave & Buster’s revelation

Angel Ackerman 1 Comment

My Sudafed is wearing off. These last two weeks of severe allergies have been exhausting and maddening as I drown in phlegm. I took my Zytrec, my Flonase and Sudafed this morning.

I learned at 9:15 a.m. that in order to make my 11 a.m. social commitment at Dave & Buster’s, I would need to accompany Eva to two clients and sit in the car from 9:45 to 10:45.

One thing about me: I can be really flexible, but once plans are made, I don’t handle change well. I am slow to recalibrate my thinking in the face of change. I had already threatened to back out of the social engagement, but now it was too late, and I would be a jerk if I had said I was going to be there and then not show. There were a limited amount of tickets, and someone else could have gone if I decided not to.

I love Dave & Buster’s, but I don’t do well in social environments. So the promise of some of my favorite arcade games– including a version of Hungry Hungry Hippos where you sit on the hippos and have to shovel the balls in their mouths– forced me to go. And more often than not, I force myself to social engagements despite social anxiety because I want people to know that I would like to support them or spend time with them.

And sometimes it can be fun.

At this point, Eva looks at me, and somehow we get to the idea that I could use a dose of Adderall. “You’d be doing me a favor,” she said. “I haven’t taken mine in more than a week, and I shouldn’t take a whole one for my first dose.”

So we split it.

By the time we got to the arcade (and I got to pet some dogs on the way), I was calm and not antsy about things. Eva came along to play some games with me, and I noticed they had removed my Hungry Hungry Hippos. I played some games, had some food, and even asked one of the teenagers to play Mario Kart.

Now, here’s the interesting part:

I struggle playing video games. My heart races and I get really anxious as if the games had real stakes. I’m really uptight about it. And Eva doesn’t like to play with me, because I’m too competitive and I get grumpy when I don’t.

Today, I played Mario Kart and enjoyed it, without stress, carrying no physical angst of the competition. I didn’t care if I lost, and even more shocking, I felt nothing when I won.

I felt no different whether I won or lost, either way it was just good fun.

It’s almost 5 p.m. now and my blood pressure is 110/69.

Overwhelming

Angel Ackerman Leave a comment

I slept really well last night and woke to a hungry cat lying beside me with anticipation in his eyes. That’s a great development for a cat that spent four years under my bed.

A few minutes after I woke up, I heard a young man speaking very loudly. I thought maybe he was walking and talking to himself. But the sound didn’t move. I looked out my bedroom window, and the young man stood in the middle of the street, gesturing quite animatedly and practically dancing with his mannerisms and yelling. At 7 a.m. on a random, rainy Sunday morning.

By 7:10, the first police car rolled up. At about 7:15, the second arrived. About 7:30, a third car arrived, and the young man reluctantly got into it.

So after that opening to the day, I opened my bedroom door to go take my shower and got ambushed by Touch of Grey, the adorable menace cat. She intimidates Canyon, the cat who lives under my bed, and I had to turn on the Roomba to extract her. When I returned from my shower, the Roomba had gotten itself stuck under a chair.

I came downstairs and grabbed the remnants of Friday’s iced latte from Plants & Coffee. Came to my desk and updated the spreadsheet I am keeping for N., my shrink-by-proxy. (For more explanation of that, it’s mentioned here. If you want to start with the beginning of my journey to explore whether or not I have ADHD, click here. And fun fact– there is a valid reason to label me neurodivergent already as I have cerebral palsy which means my brain doesn’t work normally.)

By the time I reach my desk– okay, if I’m honest I would say by the time I finished getting dressed– I am stressed. I have a social event later today at Dave & Busters. I knew when I signed up I was pushing myself outside my comfort zone, but I love Dave & Busters.

But I worry I will be the oddball in the group and not have a good time because none of my people will be there or that the people who will be there will have other people who they want to see.

And I also worry I will eat the wrong food and struggle more with my weight. I have gained three pounds recently.

I have given up on any sort of order in my life. It’s been that way for the last six months or so. Several of the things I thought would create order in my home have happened and yet the disarray still exists and I can’t fix it. And I can’t blame anyone other than myself. Let me explain.

The house is a cluttered mess. We reorganized the kitchen. Never finished the job.

We created an office for me to work in. I never finished putting stuff away.

Every room in this house is a mess.

I haven’t put my laundry away in months.

My desk is a mess– and I could fix that in ten minutes. But I don’t.

I am terrified to continue these projects/start these tasks because I worry I do not have the emotional or physical energy to finish them.

Meanwhile, tomorrow is my workshop with Laurel Wenson on The Creative Power of Journaling as part of the Easton Book Festival. This weighs heavily on my mind. I sat down to organize my final notes and in the hour since I wrote “Easton Book Festival Prep notes” in my journal, I have looked for one missing computer files, packed some pens to take to the workshop, wrote this blog entry, and haphazardly scribbled down some notes. Because I’m really struggling to focus.

And I finished the sugary latte that has made me shaky.

More assessments and more unmasking

Angel Ackerman Leave a comment

Today has already been a long day, and it’s not even noon. 11:49 a.m. but not noon.

I am holding and caressing my necklace pendant, trying to will myself to breathe and take a break. I have spent most of the day hungry and “driven by a motor” (if you do enough anxiety assessments, you recognize the language.)

I woke around seven, after getting to bed at midnight because I left the restaurant after 10 p.m. I came home, showered, reheated dinner and watched the latest episode of Doc. I went to bed, and before I drifted to sleep, I actually cuddled the cat who lives under my bed. I cuddled him for the first time, despite the fact that he has lived in my room for about five years.

I vaguely remember checking my sleep stats, weighing myself, going to the bathroom, weighing myself again, and getting dressed. I clearly remember how disappointed in myself I was for having a big fast food dinner last night and no fruits or vegetables at all yesterday and I was annoyed that I ate potato chips, because my weight stabilized after a weekend of bad eating and I probably would have hit a new low had I not eaten junk yesterday.

I came down, started laundry so my uniforms are clean for tonight and tomorrow, poured coffee, grabbed my water bottle– and had to scrub my water bottle and rinse all the dirty dishes in the sink– and then went to my desk to take my morning muscle relaxers, at double the high dose, because my movement is struggling and I’m in pain thanks to my shift at the restaurant last night. (But they gave me a floral crown.)

Working late and having an 8:30 a.m. medical appointment definitely interrupted my morning routine.

I worked on my journal pages for the morning while sitting in the doctor’s lobby. Now… what happened AT the appointment might best be summarized by my follow-up note for my long-time psychologist. Edited but presented here:

This poor woman. Her job is supposed to be to help medication management for patients who need to be monitored by a psychiatrist but are managed well enough that they don’t need heavy supervision. That sounds like a nice way to phrase it.

Last week they gave me TWO HOURS of assessments. And as I told you, I was fairly confident the psychiatrist would say I was bipolar or had GAD issues and recommend an SSRI.

He did not. So kudos to him. (His name is Dr. REDACTED by the way, which makes me happy because my dad went by that name.) He asked for deeper assessments.

So today we started with a different bipolar assessment meant to see if I have manic episodes– to which I replied, “I don’t have that kind of energy. If I did, the first thing I would do is clean my house.” 

After that one, we moved to OCD. And I can see why he asked for that one. NINE pages. (In the end I was disappointed– it wasn’t nearly as in-depth and laborious as she made it sound. There is not nearly enough standardized testing in adulthood.)

I literally said, “Great. I love paperwork. My friend is DC invites me down so we can do our taxes together.”

And she read me the first page of the Yale-Brown Assessment. Which tried my patience. I read it twice waiting for her to finish. Did I ever tell you I hate to be read to? 

The test had two columns– one for current, one for past– and the directions said to circle anything that was upsetting or disrupting to life. Well, according to the textbook definition of obsession and compulsion, nothing I do fits those categories. I absolutely know, understand and can deal with the reality that my routines do not matter or change outcomes. They are self-soothing behaviors that prevent my frustration, anger, and help me feel like my environment is under control. And I told her so. I told her that I want to be sure when I come home at the end of the day, I return to a place that I don’t need to worry about, a place where I am safe and calm. 

And she asked if I performed behaviors to achieve a goal, and I told her everything I do connects to a goal. “I am sitting here right now reminding myself that when I finish here, I get to have a cup of coffee from Panera.” 

She asked me to track my mood and my sleep– and I told her I have done both, but I periodically stop tracking mood because all it does it confirm that I worry about everything all the time and that upset me. That I last stopped probably about six months ago. And that I track my sleep every day, examine my sleep tracker every morning, and record notes every day in my journal. She asked me to take a piece of paper and make columns for mood | sleep | energy | confidence and I replied, “So, you want a spreadsheet? I have spreadsheets for everything.”

Now, I don’t know if you realize how this is going to go down. I’m going to spend the next hour working on a blog entry, then I will probably spent two hours designing a spreadsheet on Google sheets so it can be shared, that will hold the most precise data on these topics she has every seen.

And now, I am wondering if the next assessment I have to take will be to see if I am on the Autism spectrum, because numbers and spreadsheets and ABC order bring me great joy. On a scale like, in the absence of good sex, the next best high would be organizing research/data/objects. 

Oh, and I now refer to this practitioner as “shrink-by-proxy.”

And I gotta say, I respect this doctor for not jumping to the obvious conclusion. And I am now firmly in the land of medical-professionals-who-must-rule-out-all-the-things-that-I-know-are-not-the-problem” which I like better than the medical professional who assumes he just knows the answer because he’s an educated white man of a certain age.

I was not entirely accurate in my depiction of how the next almost three hours of my life would go. I came home, wrote a different blog entry completely, put my laundry in the dryer, took allergy medicine, told my daughter several stories, read someone’s comments about one of my stories, visited social media, and finally– again almost three hours after I got home– started this blog entry.

Some other thoughts from the session:

  • I will not eat or return to the run-of-the-mill activities until I design this spreadsheet.
  • I will add my pain levels to the spreadsheet and probably additional info as well because I deem it important.
  • I told them my biological siblings/father have shown evidence of ADHD
  • I explained the difference between my obession/compulsion and their criteria:
    • I follow rules rigidly, but I also break them if I know my behavior will not effect the outcome
    • My rules and routines do keep people safe (food safety, emergency preparedness) but I do not participate in them to the extent that it impacts my ability to live.
    • Keeping people safe/ maintaining a predictable environment comes from childhood trauma
    • Pattens/numbers bring me joy
    • I do not “hoard” but I will save certain items for a special occasion to the extent that they will spoil or get lost or broken– because of a scarcity mindset from insecurity caused by childhood trauma
    • I do not filter what I say or worry about what I say to the extent that I will pick “true” over “polite.”
  • Everything I do, I get done because I bribe myself with a reward when I reach the goal.

Things that didn’t come up but I wish they did:

  • I would bet money that I react to red dyes. Ask me about my childhood and my experience with Jungle Juice at the local pizzeria.
  • I have safe foods and food cycles. Same with music.
  • I have issues with sensory input and occasionally have meltdowns from overstimulation.
  • Does the world realize I have fictional characters existing in my head, telling me their story as I live my life. This alone may show how many things happen in my brain at one time.
  • I am fiercely protective of my spots: my spot on the couch, my parking spot in front of the house, where I put my possessions, how my food is organized while stored.
  • I drink my iced coffee out of old pickle jars.
  • I eat certain foods off certain dishes and with certain utensils.

I am currently very hungry but too busy to eat. My daughter has so far fed me a stale macaron and a mini cheesecake/pumpkin/coffeecake cupcake. I have had about 50 ounces of coffee and 25 ounces of water and peed at least four times since I got home. This is the precise behavior that has led to my “urge incontinence.” I thought I was getting older and therefore peeing myself when I finally realized that instead I drink insane amounts of caffeine in tandem with ridiculous amounts of water.

Off to make the coolest spreadsheet I have ever made.

Let’s talk about fidgeting (and diagnosis and disability)

Angel Ackerman Leave a comment

My daughter– the one diagnosed with ADHD and mild social anxiety– and I were discussing fidgeting. I told her that I have realized more and more that I fidget more than I ever realized.

“Mom,” she said. “You fidget more than I do.”

“I almost wish you could come with me to my appointment Thursday, because you and I have the same symptoms, but I really think they’re going to want to put me on an SSRI. Why do you get Adderall and I get an SSRI?”

“Because you are disabled.”

I must have given her a confused and shocked look.

“I am a white woman. You are a white woman with a disability. You are even further away from the standard white man. No one likes comorbidities they don’t understand.”

So, I’ve been thinking about fidgeting.

Whenever I wear jewelry, I constantly play with it. I resumed wearing my Celtic knot pendant before I traveled to Ireland in late March. I have been spinning it, touching it, and putting it in my mouth several times an hour.

When I wore a wedding ring, I spun it. And since I stopped wearing it, I rub my fingers where it used to be.

When I wear earrings, I turn them. When I had a nipple ring, I turned that, as long as people weren’t looking.

I run my fingers through my hair.

If I touch my nose or my eyebrows or my ears, I struggle to stop.

And I take notes, lots of notes. More often than not, I have a notebook and several pens in my hand. And I take photos. Of everything.

I don’t sit still well. Professionally. Personally. I excel at jobs that require sorting, organizing, finding and planning. I live life like a chess game– planning moves and tasks before they happen. Funny part is, I suck at chess. I can’t get the strategy planned out far enough ahead.

Every day it gets easier to get distracted

Angel Ackerman 1 Comment

My daughter has ADHD. She is medicated, and I can see the difference medication makes. We had no clue she had ADHD until the pandemic made her structured school life fall apart. It was like someone took her brain out of her head.

But looking back, I see some behaviors in her childhood. When she was a baby, we had to swaddle her so hard she couldn’t move at all or she would wake herself from sleep fidgeting.

Any diagnosis of clinical ADHD requires childhood presentation– and it doesn’t have to be diagnosed in childhood but there has to be some evidence that it existed in childhood even if it is a parent’s recollection or a note on a report card that says a child can’t sit still.

If you have ADHD, you get easily distracted and can’t finish tasks.

Can we take a look at that?

For those of us born in the 20th century, we had less to be distracted by. When my mother plopped me in a shopping cart, she did not hand me an ipad. I sat there. Doing nothing. Our parents didn’t schedule us for lessons or playdates or activities. They tossed us outside. My parents didn’t play with me. If I was lucky, my dad would play a half-hearted game of Uno with me while he watched the Steelers on television over my head. And no one included children in conversations or decisions or asked us what we wanted for dinner. We were told.

We have two television channels. Sometimes three– ABC, NBC, CBS. On a really good day, we also got PBS and I could watch Sesame Street. And we had to wait to see what happened next: daily for soap operas, weekly for episodic television, a month for magazines or comic books. We were trained to wait. Nothing happened instantly.

I can remember a world where you had to wait for the clothes to dry on the line. Or wait for the food to reheat in the oven. Or wait for access to a telephone or a response to a letter. If you had a pen pal overseas, you never knew when the letter would arrive.

I lived in a rural area of Pennsylvania growing up. The Slate Belt. It was a five mile drive to the little family owned store that was more like a bodega than a true grocery store. We had to drive twenty minutes to get to the Laneco or the Shoprite. We had to drive 20 minutes to get a bottle of NyQuil. A hospital? Easily thirty minutes.

Want to visit a friend? No one lived within walking distance.

When I was young, our only access to new music came from the radio. My mother had an eight-track player and a record player (and I was not allowed to touch records). I remember the first car we had with a cassette deck. My first exposure to compact discs came in college– my roommate had a CD player.

You had to wait for a song to come on the radio. And if you didn’t like the song on the radio, there wasn’t really anything else to listen to because only so many radio stations existed in the area. And each station played different styles of music. Same with TV. And movies– you had to catch them in the theaters or you missed them.

And then VCRs came out. I remember when the Sears catalog first started selling movies on videocassette. For $100 (and this was in the early 90s!), you could own the new Batman movie starring Michael Keaton. And they didn’t offer it until about six months after it left theaters. That’s why movie rental became a key element of our entertainment consumption. For $5 you could rent the movie for a night. But sometimes you had to wait to get it because other people got it first.

(Heck, we had to wait to talk to our friends– no texts, no phones in our rooms, and we shared the same phone number with everyone in our house.)

Today, I listen to music on Spotify and skip songs I don’t like. Sometimes I spend an entire car ride listening to only the first 30 seconds of every song that comes on. Sometimes I can’t find anything to watch despite six streaming channels, and other times I find myself compulsively watching a show because I have to watch all of it before I start a new show. This was a huge problem with Sister Wives because after five or six seasons, I couldn’t stand it anymore but felt committed.

When we sat down to watch television or a movie when I was a child, we didn’t have an iPhone to buzz or social media to lure us away.

When we needed clothes or shoes, we had to drive to a store and find them. And sometimes we had to check multiple stores. And if we needed something unusual, we had to find the store first. Now, we just go online and have everything and everyone at our fingertips.

While today’s kids have fidget toys, I can tell you that most of my notebooks from school have other items in the margins. Not doodles like a normal kid, but often notes for stories or observations about teachers. Was my own brain my fidget toy?

Just thoughts on a Saturday morning.

Not looking for a mental health diagnosis, I’m seeking understanding and relief.

Angel Ackerman Leave a comment

In many common injuries, and with certain illnesses and diseases, clear trajectories and treatments exist/are followed. I think in reality, nothing is ever that simple due to all the quirks that make us all the people we are.

Last year, I asked every practitioner on my care team how they felt about Valium.

Even on my beta blockers and other blood pressure medication, my heart would have these periods of elevated heart rate, even as my blood pressure was under control. And when physical circumstances coincided with these events, such as muscle pain and discomfort from too many hours at the restaurant, I would find myself taking triple my normal recommended dose of baclofen. And it didn’t relieve any of it.

So, I wondered if a low dose of valium could be a breakthrough med to relax my muscles and my heart rate. But no one on my team was comfortable with an experiment like that. I got on a list to speak to a psychiatrist. A year later I am still on that list.

A recent experiment with a dose of Adderall showed that I may respond to stimulants and/or that I have a touch of ADHD. I set up appointments with my therapist and my doctor to discuss. I got a referral to a new in-office case manager who can work with patients and report to the psychiatrist so family medicine can prescribe medication.

Earlier this week, the case manager who works for my primary care p behavioral health matters called me. She said she would talk to the psychiatrist whom she works with on my behalf, but already in that initial conversation, some of my complexities popped up.

She called me back Wednesday morning and asked if I could come in that same day or Thursday as she had time scheduled with the psychiatrist Friday. The psychiatrist recommended some screenings to give us some more information and a letter from my current therapist — whom I have been with for the last 15 years.

That in itself is hard to believe.

So God Bless him, he wrote me a letter and emailed it to me. With minimal notice.

I walked into my primary care physician’s office and, because this case manager is a new addition to the staff, they have her tucked in this odd, closet-like room in the back corner of the practice. Which had no windows. And she lit with a tiny desk lamp. Which might make some people feel cozy, but I kept thinking, “We are in a closet. In the dark.”

I screened higher than I would on the depression screening. (Which today I would do significantly better on because my good mood and hope is back– so of course that led to a mood disorder screening, which suggested I might exhibit some bipolar symptoms.) I scored “high” on the anxiety screening. And I do show symptoms of ADHD but not enough for formal diagnosis and no clear childhood presentation.

Remember– I didn’t receive medical treatment between ages 5 and 21. Except for physicals and immunizations required by law for public school and those were administered by a semi-retired doctor around the corner who only accepted cash. And this was in the 1980s: things were different.

“Did your teachers or counselors notice anything?”

Ummm… schools for GenX did not have counselors. Remember all those memes that circulate around January 28: They put a teacher on the space shuttle, shot her toward the moon, and every school age child in America watched her blow up LIVE on television. Then, they shuffled us back to our classrooms (because at my school we watched it as a group in the multi-purpose room like an assembly) and pretended it didn’t happen. I was in fifth-grade. I was almost 11-years-old.

I think every GenX (and Boomer child) understood that we were expected to sit still, do our work, get good grades, and if we didn’t the school and/or our parents would punish us– and the school could even hit us if necessary. My parents never hit me, but my mother was/is the queen of silent disappointment and perpetually pointing out individual flaws. My mother dropped out of high school, but she never hesitated to make her first statement about my report card to be about the lowest grade.

“Why did you get a B+?”

A B+.

Couple that with the childhood trauma I lived with at home– slight food insecurity, sporadic but frequent domestic violence events or risky behavior from my parents, alcohol abuse, etc.– school was my safe place. My teachers nurtured me, educated me, (sometimes even fed me and protected me) and listened to me. I would have done anything to make sure my teachers would not be disappointed in me.

So I was the perfect student. But I talked. And I often spoke inappropriately. And despite my good grades, I struggled with studying. Repetition and lots of notes are still the only way I can learn new things.

And the organization issue? Developing systems not to forget or overlook things? I had a very unpredictable household. I had to keep myself together. And my mother loves everything clean and in its place– if I left something out of place in the common areas of the house, my mother would pile it on the stairs for me to take to my room. And if I didn’t take it up, she would nag me. And if I still didn’t take it up, she would. And when she did it, she would often clean and reorganize my room while I was in school.

And if we’re looking at my borderline results for ADHD and comparing them to other brain issues, we have to consider how symptoms of depression and anxiety overlap with ADHD. And how especially adult women get treated for a mental health condition when the issue stems from neurodivergence. So am I manic– or am I hyperactive/hyperfocused? Am I depressed– or am I in a burn-out phase? (And I would add how do these correspond with hormonal cycles. When I was traditionally ‘fertile,’ I had great mood and energy, when I am approaching menstruation, I crash.)

And fatigue is also a symptom of everything. I have a history of anemia, which causes fatigue. I have a chaotic sleep schedule, which interrupts my routines and causes fatigue. I eat primarily vegetarian vegan and my B12 is on the low side of normal, is that causing fatigue? I perpetually overschedule myself. This causes fatigue. I think if depression were causing my fatigue, I would be more prone to not get out of bed. I always drag myself out of bed on time.

So, in the end, it sounds like this case manager wants a mental health history of my biological father to be the determining factor on the ADHD issue. Problem is he’s been dead for like twenty years. His ex-wife whom I knew for all of the time I knew him, also dead. My biological half-brother, I’ve never spoken with them. The few people who friended me on Facebook who share his last name and said we are family– I’m not even sure who they are.

And then there’s the issue of trauma.

I have experienced a lot of different types of trauma from the unstable environment of my childhood, a period sexual abuse by my grandfather that could have escalated had I not made the decision to avoid him, and multiple experiences in hostile work environments. (One boss who randomly fired me after recuiting me for the job to hire a friend, One boss who threw things at me. Another who made me constantly fix her personal failings. And the final one: she was an all-out tyrant.)

I even mentioned to the case manager that I had spoken with my therapist on one point about why I ended up in so many of this situations: Was it me? And the case manager rephrased some stuff I have probably heard before, but didn’t really make sense until now: You will be more prone to ignore or not notice red flags. And that made total sense. That‘s how people end up repeating cycles. You can’t recognize the subtle signs and once you are knee-deep, you rationalize, as in “the devil you know.” Or, in the case of some family cycles, the child of a drug addict might think some overconsumption of alcohol and behavior related to that is okay, because it’s “just beer.”

Note that none of this addressed the fact that I also live with a mobility disability. And my medical issues– which I am considered prediabetic now and had gestational diabetes. I have always had a strong reaction to sugar and less reaction to caffeine and alcohol. And I also react to certain chemical flavors. (I would love to find out if I react to Red 40.)

As a woman with a mobility disability, I will be extremely hesitant about any SSRI that list side effects as weight gain– I have worked really hard to lose 12 pounds and need to lose at least 20 more. This is not due to vanity. This is due to risk of Type II diabetes AND the fact that more weight will put more stress on my body that already struggles to move.

Anyway, the case manager is meeting with the psychiatrist today to discuss my case notes. If I had to guess what they will suggest, I would say they will probably try to treat my anxiety with an SSRI and refer me to a trauma therapist to explore PTSD. And I suspect they may hint at depression, or even bipolar, expecting to treat it with whatever SSRI they pick.

But I think the constant interplay of some behaviors being driven by rumination or compulsion (“I must do the dishes if the bin is full”) and my avoidance of minor, personal tasks (I struggle to put my laundry away, every time, and I’ve never developed a system) and so many other things like:

  • focusing on projects I like to the extent that I won’t stop until I’m done
  • struggling to start projects I don’t like and giving in to every distraction
  • doing several things at a time and sometimes leaving some half-finished (moving into my office)
  • lacking proper mood regulation
  • obsessing over procedure, routine, documentation and details on items I deem important
  • missing details or skipping steps on things I cannot get emotionally invested in
  • writing down tasks in 5-6 different formats while doing them as to not forget and to not worry about forgetting
  • sharing and writing down important or “pretty” numbers
  • food issues: aversion to textures, difficulty motivating myself to eat or eating too much
  • inability to recalibrate when faced with unexpected change
  • must redo entire household financial plan 30 to 60 days out every time a purchase more than $100 is made or if receiving income in that range
  • pausing in the middle of simple tasks to complete a more appealing task (I picked up my phone today while putting on flip flops and left my foot half-inserted into the shoe. A flip flop!)
  • monitoring medical information more than necessary (Blood pressure: sometimes once a week, sometimes three-times a day; Weight: at least twice a day.)
  • unable to ask for help and will instead take on large projects and complete them alone
  • feeling worthless when I do not meet my goals, no matter how big or small
  • high level of rejection sensitivity
  • always making decisions based on my “gut.”

These make life/diagnosis complicated.

I have spent about two hours on this post. It is 12:30 p.m. I have not eaten yet today. I need to pee. Because of the SEVEN medical appointments I had in the last two weeks, I am behind on some projects due Oct. 10.

And tomorrow I have a business road trip.

And Sunday, I am meeting new friends for tea.

So I need to get shit done…

Am I Alice? The White Rabbit? Or the Mad Hatter? Or the Queen of Hearts?

Angel Ackerman Leave a comment

Who doesn’t love a good mystery?

Anyone who deals with serious medical issues has experienced a sense of Wonderland. Is your regular life Wonderland? Or is the medical system Wonderland? Who is Alice? Who is the White Rabbit leading Alice down the rabbit hole?

We all have a lifetime of experiences. Some good, some bad. Some of us got “good” bodies, some of us have bodies we hate. Some of us have learned to accept our bodies. Some of us work really hard to change our bodies.

Some of us want to understand. Some of us want only to survive.

All of those things are okay.

We all have Alice in Wonderland moments.

It’s been a couple of weeks since my daughter, who has ADHD, floated the idea that she inherited the ADHD from me. It’s been one week, almost to the minute, since I took 10 mg of extended-release Adderall to test her theory, at least to give us data on if the drug brought me up or down. And the answer was down, pointing toward something not neurotypical.

And as you will see later in this entry, one of the stumbling blocks to determining what exactly my brain needs– whether that is treatment for ADHD, anxiety, depression or nothing– is, as my daughter would put it, I mask so hard even I don’t see the problems.

I have always been extremely organized, and I forgot nothing. And yesterday, at my second doctor appointment of the day, the clinician got out the standard short ADHD screening and asked the questions related to inattention. I don’t have a problem there. But I am realizing more and more, I write everything down multiple times. I write in my journal, on my paper calendar, on post-it notes, on my electronic calendar, in this blog. I write down when I take my medicine. My blood pressure.

And this morning– I went to blow my nose. Allergies are hitting in full force and Eva has an ear infection. In the middle of blowing my nose, I put the tissue down so I could take a Zyrtec before I forgot. I do not remember if I took the Zyrtec. I did not log it in my phone. The cap is off my water bottle, but did I take the pill?

Could my “obsessive” habits, like checking my bank balance several times a day, be not a form of soothing my own anxiety but something I do to prevent myself from missing something?

And even right now, as I write this, Eva has interrupted me and the entire train of thought for what I was writing completely disappeared. I had to reread the whole paragraph and reconstruct what I was trying to say. Is that normal? I’m honestly asking. So before I get too much more ahead of myself, let’s talk about yesterday.

Yesterday, I met with my longtime mental health therapist. I wrote a quick entry yesterday about that visit, posted it, somehow managed with a same day appointment with the practice who handles my everyday care, realized that the post was worse than I thought it was, and so I took it down with the intent to do a better job with new information.

And here we are.

Some observations from that appointment with the therapist who started treating me for anxiety more than 15 years ago. (That seems crazy. It can’t be that long. It just can’t.)

  • My individual complexity may prevent a simple diagnosis/solution. My history of childhood trauma and neglect, my family history of addiction, substance abuse and domestic violence. My physical disability (to which he adds “never discussed nor treated). So my brain could be doing anything for any reason. I believe this is why I’ve developed many of the habits I have that are masking how I feel on the inside. Whether we attribute this to ADHD or anxiety, that is part of the mystery.
  • Even looking back, with my history of doing and achieving all the things and doing them pretty well, it would be difficult for a clinician to trace this back to my childhood. Childhood presentation is one of the required elements for an ADHD diagnosis. (But, again, I was dealing with a lot of things, things I didn’t understand… from my body and my environment.)
  • My therapist theorized that if I have ADHD, I may have inherited it from my biological father. And that was a lightbulb moment for me. The first time I met him, I was

(I picked up my phone while typing this. I have no idea why. Got lost scrolling Instagram. Put the phone down. Realized I was in the middle of the sentence. And don’t remember what I was saying. So I distracted myself?)

  • … impressed by the breadth of his creativity and the projects he undertook. But I also remember that he had decided to remodel the bathroom and had never finished the one wall. It was still primarily the framing. Functional. But no real wall on the inside of the room. And when he and my mother split up, he went with his dog and lived in a cave in the woods until it got cold. Then it built a shelter. And when he and his wife split up, he left in his pickup truck, with his dog and a duffel bag and moved to the midwest. Where he got a job at Russell Stover chocolates.
  • My therapist can provide a letter of support to my primary care provider, and he reminded me that it didn’t matter the diagnosis if we could find a treatment that could bring relief. (And my therapist and doctor know each other so that helps.)

Now, I know “euphoria” is one reason people who don’t have ADHD take Adderall. And I’ve taken other types of medication: Lexapro for work stress and then depression (which helped in that “take the edge off” kind of way); beta blockers to control my heart rate (which failed); and Ativan for panic attacks (great, as long as I just wanted to come down and not do anything for the rest of the day). When I took Adderall, it wasn’t euphoria– it was the sensation of being able to let go of the adrenaline, the sense of doom and the constant muscle tension and being able to effectively regulate my emotions because normally my emotions also stress me out because I can’t do anything to work through them. I could on Adderall. If anything, that is what I want. I want that.

I asked my therapist: What would you recommend as my next steps? Since I have not been able to get past the waitlist for a psychiatrist, should I make an appointment with my family doctor?

I went home and called the office.

(Right now I am sitting here, forcing myself to finish this because it’s important. I need to pee. I’m very hungry. It’s 9:22 a.m. and my daughter and I are leaving for Susaquehanna Service Dogs which is sooooo exciting and stressful and… but if I don’t do this now I will not do as good of a job if I do it later and I don’t want to forget a single detail because the details can mean the difference between finding answers and getting the run-around from the medical establishment. This is how my brain works.)

I was offered an appointment with my regular provider October 13 or I could see another doctor in a couple hours. I took the appointment in a couple hours. I knew nothing would get resolved quickly, but wanted to position myself “in the system” to get the process working. That’s the hardest part of the medical system. Positioning yourself to get access to physicians and presenting the case with evidence, not anecdotal experiences.

That was why I started with my therapist. While he’s the most expensive provider on my list of medical professionals, he was the most qualified to give an opinion. Offering his opinion, based on our experience of 15 years, will hopefully show this is a legitimate possibility and not just a drug-seeking behavior. I specifically work with this therapist because he is a Ph.D. psychologist– I wanted someone who could help me grow as a person, not just medicate my brain. I have done a lot of worth in those 15 years, but recent years have shown me how much I fight myself and that I could have a chance at actually slowing down and enjoying more of my life, not just frantically surviving it and celebrating sporadic moments. Because in my brain, nothing is ever safe, or enough, or helps me overcome the doubt and doom.

(Okay, I need to get up and pee now. I’ve had 10 ounces of coffee and like 24 ounces of water… Be right back.)

(Hi, me again, I stopped to look in my protein bar basket. I should eat something. My belly hurts I’m so hungry. I have these blueberry breakfast biscuits that taste nice but don’t have any real protein. I also have a cookie dough protein energy bar from Aldi that is high in protein but full of chemicals, sugar and preservatives… I can’t decide. I have them both on my desk. I really want a piece of toast, but then I need to find and decide on bread, wait for it to toast. I should make an egg sandwich, but that is a whole undertaking of cooking. I guess I’ll open the breakfast biscuits… The taste bad. They usually don’t taste bad. And they smell weird. Are they spoiled. “Best if used by August 2025.” Did I mention I tend not to eat food I like because I might want it more another day? And then I panic that it’s not the best day to eat it? And now I’m sad that I let them spoil. Like really said. But honestly– they were Dollar Tree biscuits. So now I feel bad that I feel bad. I don’t need to beat myself up that much.

Now, do I eat the protein bar? Because I do not want to eat now. I threw out the biscuits. But I put them in my office garbage can. And the dog often gets in that can. Maybe I should empty it. Yes, let me do that quick. BRB. Again.)

So the doctor. She’s a great doctor. I mention that my daughter, and I both use the practice and my daughter does have ADHD. I tell her that I know we won’t have answers today, and I don’t expect that but I would like to start investigating this. She listens attentively and we explore the classic short ADHD. I have the anxiety-laden portion of hyperactivity impulsivity but not much else– and I ask her– I probably do fidget, but I have a spastic muscle disorder that means my legs cannot move. So how do we know? And I have similar I don’t know answers to some of the other questions. The test is inconclusive. She mentions other SSRIs. And that Wellbrutin has shown to improve symptoms of ADHD that coexist with symptoms of depression but it makes anxiety worse. And then she adds, “so that would be a bad idea for you.” And she wonders if I should try other SSRIs.

Her plan becomes three-fold:

  1. Get the letter from my therapist.
  2. Book an appointment with my regular doctor ASAP because he’s a busy guy. (Did not expect that.)
  3. She gave me a referral for a behavioral health case manager. This professional should be reaching out to me to prepare my case for review by a psychiatrist. It sounds like she does the evaluation, makes notes and gives them to the doctor so I can get medication through primary care… or through that psychiatrist. It’s a program designed for people like me who don’t have dangerous behaviors or immediate needs. And reduces the waitlist problem. That people never get off the list.

(I don’t want to write this anymore. I am forcing myself to do it. Just so you know.)

I leave the office. Hear from Eva that she got antibiotics for her ear infection. I email my therapist but then decide a phone call is more expedient and professional, so I call. He leaves me a voicemail a little later that we will get the letter together. And then the funny part– my actual primary care doctor comes to the restaurant, drives up to me in the drive-through, and chuckles when I ask what name to put on his order. He knows nothing of what I have gone through this week, or maybe he does, but I don’t think the other doctor finished her notes yet.

And that’s where all that stands.

Now if you’ll excuse me, it’s cold this morning and I am debating making a can of Spaghetti-O’s for breakfast.

The ADHD rabbit hole

Angel Ackerman Leave a comment

My daughter, now in her senior year at Lafayette College as a psychology major, has been armchair diagnosing our friends and family since her early high school days when she would read the DSM-V for fun. It’s fascinating for me as a parent to hear my child talk academically about topics and use language outside my understanding. And I do enjoy it.

If you know me, or you’ve read this blog for any significant time, you may know that I have struggled with my mental health. I exhibit symptoms of anxiety and depression from time to time, love routine yet challenge rules, obsess over numbers and patterns, overschedule myself and never relax. And the funniest part of that– I have gotten better about these things.

Through casual observations, it seems obvious that ADHD runs in my husband’s family.

But my daughter continued to study people– and me– and one by one she made her diagnoses. “Your dad had a type,” she said to me once. “His wives were all narcissists.” Or she’d suggest a medication to a friend looking for relief. And I have never seen her be wrong.

She has recently declared that her father is “autistic as all shit,” (which my mental health therapist had suggested might be the case more than a decade ago) and that she thought that she “inherited her ADHD” from me.

I protested. “My executive function is fine.”

“Is it, Mom?”

Her words make me recall a conversation I had with a friend of mine before I left for Ireland in the spring. I don’t even remember details of what we said, but it was a business call, and I remember listening to this woman I respect and adore the creative work of, a woman who had ADHD, and thinking “that sounds a lot like me.”

At Eva’s urging, and her constant reminder that traditional medical research applies to 40-year-old white men, I looked at the symptoms. And when I google information, I always evaluate the source. I look for articles from medical centers, government agencies, professional organizations and publications like Psychology Today. (It may reduce everything to layman’s terms but it does have a responsibility to be accurate.)

These are symptoms of hyperactive impulsive ADHD in adult women that spoke to me:

  • racing thoughts
  • subtle fidgeting
  • excessive talking
  • overcommitting
  • burnout
  • rejection sensitivity
  • hiding internal struggles to appear calm and organized
  • burn out
  • signs of anxiety
  • signs of depression

Let those last couple sink in. Women with ADHD are commonly misdiagnosed and treated for anxiety and depression.

I wonder if I would be more restless and move more if I didn’t have spastic cerebral palsy that prevents my legs from doing things. The more I pay attention, the more I see how my daughter’s ADHD habits totally mimic my own. And I never noticed.

And I know people with ADHD often self-medicate with caffeine and sugar. I never experienced a cup of coffee calming my thoughts, but I do know I can drink a lot of caffeine with minimal reaction but I get a sugar high really easily.

I am also prone to hyperfixation. And taking on hobbies with gusto and then suddenly never doing them again. It’s like one of my existing hobbies will suddenly explode and become all I do and then, one day, I never wanted to do it again. When Eva was born, I made something like 18 scrapbooks in her first three years of life. Since she turned 4, I did not have a photograph printed. (I blame the iPhone. Not my brain.)

As a well-behaved patient should, I called my mental health therapist/psychologist to see if we can explore this idea. He will see me Thursday. And it might be wishful thinking, but he sounded like the concept might have triggered a “lightbulb” moment for him– because I know he has grappled to find “what I need.” His formal diagnosis has stated that I exhibit occasional symptons of generalized depression and anxiety.

Any good theory deserves an experiment. So, after a few online surveys, I took a trial dose of Adderall. I was terrified to do so. I have issues with high heart rate. I was fairly confident I would be very uncomfortable.

And then, in a conversation with my daughter about 20-30 minutes in, my brain felt soft. And then about 40 minutes in, my hands started tingling. All my fingertips felt weird.

“Mom?” my daughter said. “Is something happening? How do you feel?”

“My brain feels like goo,” I told her. “And something’s wrong with my hands.”

She took my hands and looked at them. “What’s wrong?”

“They’re tingly.”

“Mom,” she said. “They’re warm. That’s all. You have circulation. Your hands are not cold.”

My hands and feet are never warm. My body temperature is usually around 96 degrees. I had first-wave COVID, and my “fever” was a body temp of 99 degrees. And even on the hottest summer day, my hands are usually chilly when other people touch them.

And in that moment, I knew I had slowed down. It was like someone just took the energy that was “me” and turned down the flame a couple notches. I read my tarot cards; they felt it. I went to the grocery store and casually looked at the options and didn’t run from one aisle to the next. I wrote a Substack newsletter. Because I wanted a record to see if my writing had changed. (You can read that here.)

All the stuff I normally worried about and used all my energy to “do,” it didn’t feel urgent. I laughed easier. Moved slower.

I remember the day my daughter first took her ADHD medication. She was standing at the table in her grandparents’ kitchen, animatedly telling a story. As I listened, I realized that she had stopped vibrating.

I had stopped vibrating.

“It’s like your aura has changed,” my daughter said.

“I’m calm,” I replied.

“I never understood what you meant when you said that I ‘stopped vibrating,'” she said. “I get it now.”

I had stopped vibrating.

The thought that I really could stop vibrating made me want to cry– from relief, because of the new understanding, in fear that I would never feel this way again, hope that I could.

I slept like a baby that night. And the next few days I went back to being me. The me I know. My heart rate and blood pressure hadn’t been impacted.

We opted to do the next trial dose yesterday. I was meeting a good friend and wanted to see if she saw a difference. I was scheduled at the restaurant. I wanted to see how it felt in a different environment.

I took the medicine. Went to Panera for my writing date. I drank herbal tea to be safe. At 9 a.m. I caved. I had 12 ounces of coffee. And then about 6 more. It did not disrupt my zen. I did my writing. I was less talkative.

I came home, did more work on my personal project because I wanted to, and I didn’t fret about all the things I “should” do. I knew I would do the things I should, but I didn’t stress over doing them right now. Then, I watched TV for a while. And I didn’t feel guilty about it. My daughter came home from school and her 3:30 dog walk canceled so we didn’t have to rush out the door. I sat on the couch and chatted. I didn’t try to do more.

Now, the medicine should have worn off by the time I went to work at the restaurant. But I don’t think it did. I sat in the lobby watching everyone. It made me happy to sit and watch them. I thought they were moving slowly. That maybe the restaurant wasn’t the busy place I thought it was. I am often stressed by the fact that the kids I work with don’t think anything is urgent. Maybe they are right. My heart was not racing in anticipation of my shift.

I was not thinking about all the stressful things that could happen.

But as the medicine started to wear off, the restaurant got busier. But even as my heartrate and workload increased, I didn’t feel the “panic” I would normally feel. I didn’t feel the need to analyse and make a plan every two seconds. And then I thought of the perfect way to phrase it– because I got moved to a work center that stresses me out– even though the medicine was wearing off and I could feel the stress in my body, my brain and my behavior were not motivated by a sense of impending doom and disaster. I know that sounds dramatic, but every piece of stress I feel it my body feels like if I don’t keep up with the moment/the environment/the task, I will face a disaster.

Remember the television show LOST? There was a button on the island that someone had to push. I believe it was every twenty minutes. No one knew what the button did, but they all believed that if they didn’t push the button, something terrible would happen.

My brain is pushing that button all the time.

But on the show, I believe something bad did happen when they did not push the button.

And I feel like even when I did not have the full effect of the medication in play, my sense of doom dissipated. And that was amazing.

When I took this medication, I felt like I could relax. I have been wishing for decades that I could find a way to relax. I thought I needed a hobby, not amphetamines.

And today my daughter tells me that cerebral palsy is also lumped into the neurodivergant classification… More to think about.

**I cannot find much information on this, but my anecdotal experience on medication suggests that although it should not, my mobility and spasticity improves when I take Adderall. My experience feels like I no longer hold as much stress and tension in mu muscles. Which is why I wanted the small dose of Valium. Maybe I need the opposite?