Well, then. It’s been about oh….a little over a month.
Yeah. Sorry about that.
Strangely, even though I don’t at all remember the topic of my last post, I did remember I should be writing. I just…didn’t.
It’s not a personal reason. It’s not a good reason. It’s not even really a reason, actually. I just didn’t write.
Shocker, but I think depression is to blame. I go through good months and bad months. This particular month, I saw a psychiatrist. On purpose, even. I went with a specific goal in mind: I wanted to get a new and hopefully effective antidepressant. I also wanted to find out if there was a better way to manage my ADHD, which is pretty bad.
However, the appointment kind of…got away from me.
I informed the psychiatrist that I was looking for a new antidepressant, explained that I hadn’t been on one since September of 2021 (I know, right? wtf), and that weight gain was a deal breaker for me. I’m already a formidable presence at 6 ft and about 230. I don’t want to be an actual sideshow, you know what I mean?
Then I told her that I was interested in a different medication for my ADHD.
She point blank looked at me and said, “you don’t have ADHD. There’s no such thing as adult ADHD. You have effects from your stroke. That’s all.”
So, like…K. I don’t actually exist in the way that I thought I did then? All of the symptoms I had before my stroke, the diagnosis of hyperactivity when I was about 5 (ADHD wasn’t recognized as a thing in the late ‘70s, early ‘80s, we were all just problem children, daydreamers, overly active for you know, no good reason).
Which apparently this doctor believed I was now.
Well, ok, not with no reason this time. I had a reason. But it wasn’t what I thought.
I have thoughts. Oh, so many thoughts.
First off, regardless of whether I had ADHD to begin with, or something else, something like an active imagination or maybe just no real sense of reality, I had coping mechanisms.
Coping mechanisms that are now either just gone, or are no longer available to me.
First off, let’s examine my complete dependance on caffeine. It was bad. Really, rather a lot of caffeine was being consumed.
It’s a common thing, yes. More common in people trying to balance out all of the overactiveness that occurs with ADHD. I don’t know a single person with ADHD who isn’t pretty much hooked on caffeine. Some are hooked on far worse.
What the heck, dude? I can hear you thinking. Caffeine isn’t even a decent drug. It just wakes you up in the morning.
Well, that’s wrong for a lot of people. Caffeine creates a dependence. It’s much easier to kick this dependence than it is other dependences. But keep in mind, way back when coffee first hit Europe, it was looked upon as almost an illicit substance. Women weren’t allowed in. Men met and discussed all manner of important topics. People from towns, pastors of churches, many people would condemn the coffee dens as prone to iniquity. They accused the people who frequented coffee dens of being reprobates.
Caffeine was a big deal. It’s now just a ubiquitous part of society.
So, yes. Caffeine counts as a drug, it’s just a legal one.
Why this works to help people manage their ADHD is because, with ADHD, caffeine makes things sharper. It lessens the distractions that constantly pull you in 17 different directions when you just want to do that one freaking spreadsheet for work and get on to the next task.
At this point, ADHD is treated in a couple of different ways. Originally, in the mid ‘80s and still today, it was treated by administering stimulants. Caffeine is a stimulant, though a legal one. That’s why it wakes so many people up every morning. Ritalin is one such stimulant. It’s honestly why ritalin is an issue now, with people selling their meds to people. A) It’s saleable, and money is attractive. B) It’s a stimulant to most people, and a lot of people use it for an edge.
Again, ritalin, or any stimulant does not provide a person with ADHD an edge, it provides the opposite.
Anyway, I digress.
So, after that thrilling revelation, in which my whole idea of how everything was with me came crashing down around my ears, the psychiatrist did have a different suggestion, which I will try, when I get the meds. She suggested a med commonly used to treat Alzheimers and dementia. I’m up for it. I will honestly try pretty much anything at this point.
See, the whole thing is complicated, obviously. Without the antidepressant, I have no ambition to do, well, pretty much anything. Without the treatment for ADHD, I have…no real impetus to do anything either. The mix of the two means that I am now a rather ineffective housewife, which is my primary job now.
I do not dislike being a housewife. However, it is far more interesting if you can figure out what you want to do, and then actually do those things. I was doing that pretty well for a while.
Since about September of last year, I’m not.
I can’t figure out what I need to do, or exactly how I need to do it.
And I have a ton of stuff I want and need to do.
Which leads to…Ta Da! More depression. And I really have enough of that anyway.
I haven’t taken my ritalin since that appointment. Why should I, if, by the reckoning of a medical professional, an MD even, I don’t have the condition that it treats?
My husband has told me on several occasions that he notices a difference in my clarity of thought and my ability to accomplish things when I take the ritalin. I don’t notice it. I just notice when I don’t do all of the things.
Without the confirmation of a medical diagnosis, what I’m left with is “Well, shit. I guess I’m just lazy.”
I’m not entirely sure that was the psychiatrist’s intent. I’m pretty sure it wasn’t, actually. She was just putting out information that she knew to be true. Which is fine, I guess, but also not true.
How, I keep wondering, do people with ADHD outgrow it? They know it’s an issue with brain chemicals, usually serotonin, melatonin, endorphins and dopamine. They either aren’t produced in enough quantity, or are reabsorbed too quickly to have the desired effects.
For those who don’t really know what ADHD is like, I’ll try to outline it for you a bit.
So, you have all these chemicals that your brain naturally produces. According to mayoclinic.org, “Serotonin is a neurotransmitter that mediate(s) satisfaction, happiness and optimism.” Melatonin is a hormone that plays a part in a person’s sleep pattern (a huge part, actually, if you’ve ever taken melatonin, you know). Endorphins are the body’s natural pain meds, and kick in if you exercise or injure yourself. If you’ve ever had a bad headache, or a lot of pain for any specific reason, and had that sudden feeling of almost euphoria when the pain lessened, you know endorphins. From clevelandclinic.org: “plays a role in many important body functions, including movement, memory and pleasurable reward and motivation.”
As I mentioned, these are all neurotransmitters and hormones that are not supplied in sufficient amounts to a person with ADHD, and we definitely notice the lack of them, even if we haven’t had the advantage of them working for us, you know, ever.
It may seem kind of ridiculous, but for a second, if you don’t have ADHD, picture handling any situation without the bonus of these components. Then imagine that after such an event, you can’t sleep.
That, in a nutshell, is ADHD. You could be injured, but your body doesn’t produce a good flow of endorphins, so you just hurt. Then, while dealing with that, you go to lay down and can’t stop yourself from constantly thinking and then rethinking, then you also can’t sleep. You’re not even technically sleepy, even though your brain is just running on fumes. So, you stare at your ceiling, try to breathe, and fail to rest.
It’s pretty heinous.
I luckily haven’t had any issues with my endorphins. Which is a relief, because I have had some very painful things happen. But I am an insomniac. Even when I was recovering from my stroke, I couldn’t sleep more than a couple of hours at a time. I use a CPAP now for apnea, which helps, but if I don’t take my sleeping med, I wake up several times per night.
Which brings me to my next point: Sleeping is boring.
What?! How can it be boring? You’re sleeping!
Well, when you’re awake a lot while you sleep, it’s boring. You have time to think when you wake up while sleeping. And it sucks.
I always was so envious of my cousins, who could sleep for like 12 hours at a shot and be fine, great even, when they woke up.
If I sleep 12 hours I don’t know what freakin’ century it is. For real. I’m lost.
And, if you were wondering, yes, it is pretty terrible to have sleeping issues with a brain injury. It sucks, actually. Everyone is telling you that you need to sleep at the very least 8 hours per night, preferably 10, and yet there you are, after failing to fall asleep for four hours, showing up at the nurses’ station for a cup of hot cocoa at 1am.
Thank God for sympathetic nurses. Night shift nurses so rock. I mean so do day nurses, but honestly, you guys are awesome. Never could have done all this without you.
I didn’t actually cover the dopamine part. Dopamine has gotten a lot of press, as it’s a primary issue with people with Parkinson’s Disease. Parkinson’s is rough. Don’t let anyone ever tell you otherwise. If you have it, honestly, you have my heartfelt virtual hugs.
But, aside from the movement part (in ADHD that usually shows up as “is uncoordinated” on a person’s report card), dopamine is the thing that gives you the “Hey, good job doing the thing” feeling. You get a hit of it after workouts, or after difficult tasks. It’s what makes you want to do the thing again, even if it was a truly arduous experience.
In short (way too late for that, I’m afraid), ADHD means the brain doesn’t supply the body’s natural rewards. Which, to be honest, really kind of sucks. And I don’t really understand how a person could “grow out of” ADHD. What, do you suddenly and for no particular reason, develop the ability to produce and retain those neurotransmitters and hormones? Nope. That doesn’t make sense. At what age would that happen? Certainly not 13. Definitely not 18. 21 is just an arbitrary number at which people can drink alcohol in the US. Maybe 25, that weird age where you’re suddenly an actual adult who doesn’t have to put your parents financial status on your FAFSA? Nope. It doesn’t go away.
Not that we don’t know what these rewards feel like. We do. We have a tendency to get these weird “dumps” of said chemicals. Which is where the hyperactivity part comes in, because when you feel good, you want to move! You want to run! Or cook! Or drive! Or create! Whatever you want to do at that moment, it’s an actual imperative that you can’t ignore. This is, for some reason, the part most other people have the biggest trouble dealing with. Mostly because we’re hard to keep up with, I guess.
Hey, at least at that point, we’re happy. Which brings me to my next point: Comorbidity.
Like most diseases, ADHD has a comorbid element; a comorbid is another condition that occurs simultaneously. In our case, it’s usually depression or anxiety, or for some truly unlucky people, both. I have the depression component. My youngest son has anxiety. As you can imagine, none of this was helped by my stroke. Not for me, but definitely not for him. It’s a heavy load, really. And I’m gutted that he has to carry it.
And that’s my last point for today: The genetic component. ADHD is, as far as I can figure, though I admittedly haven’t read much on the subject, hereditary.
My mom definitely has it, but she was born in the early 50s and precisely no one had a clue back then. My suspicion is that my maternal grandmother had it, as well. She’s no longer around to ask. But my grandmother absolutely lived on caffeine and nicotine. Nicotine is also a stimulant. I know that was indicative of the time period, but it was pretty major. She didn’t eat much as a result, and was incredibly thin her entire life. She also slept terribly and really didn’t stop moving.
So you can see where my suspicions come from. I mean, seems legit to me.
