Monday, October 31, 2011

Gender Roles

We have to make weekly discussion board posts in my human development class and I thought this one was worth sharing:

_____

I found this to be one of the most interesting chapters in the book.

I think the socially placed gender roles (particularly prevelant in the South) have dramatically shaped my life more that I would have liked. Unfortunately I eschewed many traditional "female" activities at the expense of my own happiness (gardening, artistic endeavors, cooking). I think that there are some clear biological differences in the sexes (some are highlighted in the tragic and unfortunate case of David Reimer - here is an interesting documentary here - http://www.youtube.com/watch?v=MUTcwqR4Q4Y&feature=related) but the extent that we impose these views on children overreaches by any reasonable measure. I think it is also important to remember that in aggregate there may be differences between the sexes in terms of things like aggressiveness or verbal acuity, but the individual differences with in a given sex are so extreme that their utility marginal when applied to any to any single real person.

There is an interesting case in Toronto that I came across earlier this year. I posted it on Facebook and had a healthy discussion with several friends about it.

Parents Won't Reveal Gender of 4-Month-Old


I think gender roles are similar to childhood traditions like Santa and the Easter Bunny. I have long said I doubt I will teach my children to "believe" in Santa and the Easter Bunny because I think it does more harm than good to lie to children and have them believe things that are not real. This does not however mean that I cannot teach them about the stories or that they are prevented from enjoying them. They are important in popular culture and to ignore them would be a disservice. I think that in general gender roles might need to fall into this bucket too. Children should be free to enjoy the things they enjoy without any pressure from others. Unfortunately the world is cruel and will try to get them to conform. Hopefully they can still enjoy life in the face of these things.


Saturday, October 29, 2011

For every ailment under the sun
There is a remedy, or there is none;
If there be one, try to find it;
If there be none, never mind it.

Friday, October 28, 2011

The "ADHD Personality": Its Cognitive, Biological, and Evolutionary Foundations

Basically the same conclusion I have come to as well... It's a disposition as much as it is a "disorder" and like and personality, you have to find out where you fit...

"The trick, for each person, is to find niches within their environment that play to their strengths rather than to their weaknesses. In general, people who are highly controlled are great in jobs that require lots of reflection and relatively little action, and people who are highly impulsive are great in jobs that require lots of action with relatively little time for reflection. This has nothing to do with degree of intelligence. You can be intelligent and impulsive, making terrific snap judgments; and you can also be intelligent and reflective, making good judgments after thinking things through very carefully."

Here is the original article.

I am a pretty textbook case, and it's interesting to see how my past has been pretty drastically altered by the common traits shared by others with ADHD. I think the awareness of this is most important part. One, so I understand myself and don't have to feel guilty about who I am and two, so I am able to warn people and they can better accommodate me and adjust their expectations for my behavior and what my known weaknesses are.

For instance, if someone had a friend with a bad knee and they wanted him to come along on some camping/hiking trip they would in some ways have to plan the trip around his ability to walk. I think this is similar. I am just not capable of doing some things that others can and I think the best approach is to work with what I am given because there are also some clear benefits to ADD that I enjoy (he highlights some in the article). I also consider these aspects to be essential to who I am - aversion to small talk, my periods of "hyperfocus", how quickly I let go of anger, how I am always searching for improvement, my high level of energy. They all have a negative aspect too, but I am ok with who I am (except for the part where I am sort with people I care about and how I have trouble having linear conversations.

I think the general point is that I should find a lifestyle that works with who I am and to use medication when necessary (say for boring tasks like studying or writing a long paper) but in general I think I would be fighting an unwinnable battle if I try to change my entire way of thinking/being simply to fit in.

Which is exactly why the put ADD "personality" in the title in quotation marks. The point was to draw attention to the fact that maybe it should treated like that instead of a full blown disease.

A love hate relationship with myself

Good book on ADHD and my reflections

I just started reading Attention Deficit Disorder: The Unfocused Mind in Children and Adults and it feels like therapy as I turn each page . I would certainly suggest it to anyone who wants to know more (it offers a good mix of personal accounts and a good account of the biochemical, neurological and cognitive aspects of the condition)... though I will say it's leaving me with a strange mix of emotions. I can't get over the conflicting thoughts of feeling broken, wanting to change and yet wanting to be able to "fix myself" on my own and being unable to do so without medication.I hadn't realized how many different areas of my life this condition has impacted. On a spiritual level if I start taking medication it means i many ways I am letting go of these distinctly American notions of individuality and admit that I am finally fully committing myself to "the interdependent web of all existence of which we are a part." It also means I have a lot of explaining to do people in my past.

It's just so hard to read this book, look back at my life and many of my biggest problems, and see the similarities between my own life and the stories of those shared on each page. I see myself now and cannot help but look back to all the situations where I have been socially awkward, late, forgetful, antsy, hurt people I cared about, stressed myself out for no reason, and struggled in areas where I should't have had to. It just seems so improbable that they could all be tied to this single issue.

I still don't know if I will find a pharmacological or therapeutic solution to the issue either so I guess I m rather hesitant to throw my attention towards change rather than just accepting who I am and being more clear with others about the disconnect between my desires and actions and the level of understanding that is needed when bring my friend. I like me and would rather just find people who like me too rather than trying to do what I need to do fit in more easily with others and in the "professional" world.

That being said, the biggest appeal of the drugs is not increased academic or work performance. I don't think I would start them if that was the reason. After reading/talking/reflecting I feel like the potential for clarity in my thoughts is too appealing to pass up. My biggest desire has been to sedate my restless, wandering spirit and find lasting meaning and purpose. I want to be able to be happy with the situations I am in and with the people I have in my life. I want to be able to control my emotions and express myself clearly. I want to be able to set my mind to do things, think it through as far as I can without getting distracted, and then be satisfied with my decision.

Thursday, October 27, 2011

Self Medicating

I have been doing some reading and reflecting on my own family history (putting my father's 2 pack a day smoking habit in context) and started researching the effect of nicotine (since most ADHD drugs are stimulants) and found some pretty compelling data.

I am pretty impressed with this little guy.

Below are excerpts from two VERY interesting articles on nicotine. The key points are below....

__________

"Behavior inhibition was significantly improved by nicotine compared with placebo in the HI group and impaired by mecamylamine in the CTRL group. Go signal reaction time on the stop signal task was improved by nicotine compared with placebo in the CTRL group and was unchanged in both groups on the choice reaction time test.

"Thus, self-administered nicotine induces a persistent amplification in the brain's sensitivity to rewarding stimuli, an action of nicotine that appears fundamentally different from the long-term actions of other drugs of abuse such as cocaine (Markou and Koob, 1991; Ahmed et al, 2002; Kenny et al, 2003) or heroin (Kenny, Chen, Markou, and Koob, unpublished observations) that usually results in long-term compensatory decreases in the activity of brain reward systems during the early abstinence period."

___________

Anyway... If the mechanism works the same way in humans I think this would explain why nicotine works so well for those with ADHD. Nicotine actually makes less interesting tasks bearable by reducing the reward sensitivity. It would also in part explain the reduction in impulsive behavior in people given they don't have to constantly seek things which will stimulate them.

In any case I have ordered some nicotine gum and plan to self-administer 4mg a day and closely monitory my results.


Keeping my fingers crossed....

Update: 6/27/2012
I tried this for one week, and noticed a very relaxing effect, but after seeing other smokers and hearing of withdrawal problems I decided I did not want to get hooked and quit self-administering.

Wednesday, October 26, 2011

Looking around the library, watching everyone else study, and feeling a little sad.

Everyone else is in groups and I am by myself. I have always done things this way and honestly I have never been able to get much help from group study other than keeping me motivated. I typically have trouble articulating my questions when I am confused and if I have just learned something I usually can't explain it very well and end up confusing everyone more than helping them.

I also wonder if my personality has made it difficult for others to want to be around me. I know as a child it was probably this way and I wonder if it still is or if I have just adapted to doing things by myself...

Googled some stuff, which didn't help my mood....
_____

Went to the psychiatrist today. Scheduled appointments for counseling and signed up to join a group with others who have ADD to help coach some basic skills. I read a lot about Strattera (what they will probably put me on) and the other other class of drugs like Adderall (mostly stimulants).

It seems like we have a long way to go, but the effectiveness of the drugs is pretty amazing given the total lack of specificity of the drugs on the particular regions of the brain - essentially it increases concentrations of norepinephrine (which does a ton of different things in the body from controlling heart rate to the flight or fight response - norepinephrine is a precursor to epinephrine which is adrenaline) by preventing the body from reabsorbing it - thus increasing the concentration in the blood. Stimulants to this and also for dopamine (which is why they are addictive and subject to abuse).

Anyway, I feel glad I am making steps to deal with it regardless of what path I choose. I also feel better now that I have included my parents in the decision.

Monday, October 24, 2011

On our own terms...

Below are some excerpts from a good article I read the other month. I
was just going through some notes and thought it was worth sharing....
------
" I apply the tools of econometrics a few times a year, but I apply my
knowledge of the purpose of my life every day. It's the single most
useful thing I've ever learned. I promise my students that if they
take the time to figure out their life purpose, they'll look back on
it as the most important thing they discovered at HBS. If they don't
figure it out, they will just sail off without a rudder and get
buffeted in the very rough seas of life. Clarity about their purpose
will trump knowledge of activity-based costing, balanced scorecards,
core competence, disruptive innovation, the four Ps, and the five
forces."
-----
When people who have a high need for achievement—and that includes all
Harvard Business School graduates—have an extra half hour of time or
an extra ounce of energy, they'll unconsciously allocate it to
activities that yield the most tangible accomplishments. And our
careers provide the most concrete evidence that we're moving
forward.You ship a product, finish a design, complete a presentation,
close a sale, teach a class, publish a paper, get paid, get promoted.
In contrast, investing time and energy in your relationship with your
spouse and children typically doesn't offer that same immediate sense
of achievement. Kids misbehave every day. It's really not until 20
years down the road that you can put your hands on your hips and say,
"I raised a good son or a good daughter." You can neglect your
relationship with your spouse, and on a day-to-day basis, it doesn't
seem as if things are deteriorating. People who are driven to excel
have this unconscious propensity to underinvest in their families and
overinvest in their careers—even though intimate and loving
relationships with their families are the most powerful and enduring
source of happiness.
-----
I have a pretty clear idea of how my ideas have generated enormous
revenue for companies that have used my research; I know I've had a
substantial impact. But as I've confronted this disease, it's been
interesting to see how unimportant that impact is to me now. I've
concluded that the metric by which God will assess my life isn't
dollars but the individual people whose lives I've touched.
I think that's the way it will work for us all. Don't worry about the
level of individual prominence you have achieved; worry about the
individuals you have helped become better people. This is my final
recommendation: Think about the metric by which your life will be
judged, and make a resolution to live every day so that in the end,
your life will be judged a success.
-----




Wednesday, October 19, 2011

Tuesday, October 18, 2011

I saw this on a site about ADD and found it pretty interesting. I can certainly relate....
  1. Emotion: managing frustration and modulating emotions. Although DSM-IV does not recognize any symptoms related to the management of emotion as an aspect of ADHD, many with this disorder describe chronic difficulties managing frustration, anger, worry, disappointment, desire, and other emotions. They speak as though these emotions, when experienced, take over their thinking as a computer virus invades a computer, making it impossible for them give attention to anything else. They find it very difficult to get the emotion into perspective, to put it to the back of their mind, and to get on with what they need to do.

Monday, October 17, 2011

I feel like I am finally getting a clear ethical base for my decision making process. It has taken a long time (mainly because so many people argue to prove whatever they said in the past was right [myself included] AND because people like to polarize things) rather than letting down their defenses and talking about the issue itself. That's why I don't talk to fundamentalists - because they think they have already found truth (and why I like Unitarians). But anyway, I feel like the effort I have put in over the past two years is paying off. I feel less conflicted when I make decisions or express political sentiments. In a lot of ways I have let go of many ideas and detached them from my ego which has let me see them for what they are.

Or to quote Mr.Neruda... "Forgetting lasts so long"

Yes it does... but I feel like I have made lot of progress...

---

In other news I also decided to go get formally screened for ADD at the university counseling center which should lead to a visit to the psychiatrist and then a prescription. This route will be free, and given that, I I can't see the harm in trying the medication for a short while. I had a long conversation today with a friend (who is about 6 years older than me) who just decided to start medication. We both had common fears about personality/addiction as well as dissatisfaction with our current level of productivity. This along with the obvious fact that it has been studied by thousands for decades was enough to assuage my doubts.
People are often unreasonable and self-centered. Forgive them anyway. If you are kind, people may accuse you of ulterior motives. Be kind anyway. If you are honest, people may cheat you. Be honest anyway. If you find happiness, people may be jealous. Be happy anyway. The good you do today may be forgotten tomorrow. Do good anyway. Give the world your best and it may not be enough. Give your best anyway. In the end it is between you and God. It was never between you and them anyway. 
-Mother Teresa

Reflections on managing ADD / ADHD without medication....

I was reading an article on ADD and I thought the comment at the below might be helpful for me. At the bottom I have also included a review of my experiences on ADHD meds

"Notes, lists, a decent calendar with alarms (I use my phone’s functions), along with conservative intelligent supplementation (multivitamin, Omega 3s, tyrosine, GABA, etc.), green tea, EFT (tapping), consistent intense exercise, increased protein intake, journaling, and studying ‘thought mechanics’ (NLP, RET, CBT, etc.) all really help me - far FAR more than the expensive, incapacitating meds and time-consuming, inconvenient, doctor (10 minutes) visits EVER did.

I guess this means I should probably be rather diligent over the next few months as I devise a plan (exercise, diet, coffee, more lists/structure) to manage the things I need to do in life before I turn to medication. It also explicitly stated what I have been doing all along with the help of technology like the iPhone and other products from Google (auto reminder calendar emails, persistent alarms) . I would be lost without the things they have provided.

____
Update: 2/12/2013

Exercise helps tremendously. Cardio and yoga (at least from the research I encountered and my own personal experience) have much more profound effects on my sleep, focus and mood. I do not think it is merely a coincidence that exercise and stimulant meds both release dopamine and have similar effects. It also makes a lot of intuitive sense that dopamine is related to pleasure and might serve to make less pleasurable (ie boring) tasks more enjoyable, or at least bearable. I also feel like I have pent up energy and when I don't release it, that it exits my body in the form of over-activity or in repetitive movements like rocking, foot tapping or bouncing my legs while sitting. When I exercise I deplete these stores of energy and can be a little more relaxed.

I also benefitted from my rather odd spiritual journey which led me to attend both Buddhist (Soto-Zen and Kadampa) and an unprogrammed Quaker service. They both heavily feature silence/meditation as part of their services. The process of not pursing a train of though, letting other thoughts bubble up and then finding a quiet stillness within has helped me in daily life. If one can control the mind, the body is simply an afterthought.  Being able to sit quietly and find peace is a precursor to most other lasting forms of happiness. Otherwise we are going to just continue to see activities to avoid this rather natural state of being.

Coffee does help, but it's only good for short periods of time. It pushes my mind beyond it's normal limits leaving me a bit weary, but at the same time interrupting my normal sleep patterns. This is fine for a day or two if I have an important project to work on, but I don't think it should be an everyday thing (nor do I need the horsepower coffee provides on a daily basis). Along these lines abstaining from alcohol, Facebook and sex (each for 30 days) gave me some additional insight into what causes my distracted mind. The incessant quest for the opposite sex (probably for intercourse and a shot of dopamine), the stream of status updates (talk about a positive behavioral re-enforcer and a perpetual distraction from reality and those around me - it became a way to plug the hole of boredom), and the numbing of my mind by alcohol to slow the stream of thoughts. They all are fine, but if used on a daily basis they begin to exacerbate my own inability to focus.

I also modified my diet, taking basic advice from the glycemic index tables. They were really revealing as some of the effects on blood sugar are rather unexpected. Fruits, while loaded with sugars, tend to only raise blood sugar by about half the amount of refined grains. I now make sure to use these high GI foods sparingly and try to eat meals that won't leave me feeling drowsy (I can't get any work doing this). At my old job I would often eat a meal that would leave me drowsy, then I would load up on caffeine in the afternoon which would leave my mind racing (to the point that I couldn't keep up or do anything) and then I would also be left, as I mentioned above, with an interrupted sleep patterns. It was all a very vicious cycle.
___


One thing that concerns me the most, and prompts my desire to change is that ADD frequently prevents people from living up to their potential and I have noticed that my own aversion to careers that require great attention to detail (most occupations, particularly at entry-level) because of facets of my personality that are a result of my ADD-like traits (aversion to small details, inability to finish projects, antsy-ness). I don't want to limit myself to relatively "detail-free" careers simply because of my condition. I also see many long term jobs (higher level) that I know I could never rise to because I lack the ability to work my way from the ground up -jobs which I would enjoy, but have written off because I do not have the ability to perform lower-level tasks efficiently. I also wonder that if my system of managing tasks turns out to be successful I may just be putting myself into a position that allows me to be a functioning (but still rather handicapped) adult. Will my concerns about taking medication prevent me from giving back and taking care of myself.

All of these thing make me want to take medication, though the other side of me says I should simply accept myself as I am and create the life I want with what I was given. But then again, how is any of this different from Tylenol or coffee or alcohol. Three things which alter my personality and and one of which is highly manufactured. It seems ideologically inconsistent to take those and yet be reluctant to ADD meds.

ADD/ADHD often causes social problems but thankfully, over the past year I have been (or at least I think I am) much better about managing the emotional traits that bother others the most. However, as I just mentioned I still struggle with those that are required for the more boring parts everyday life (school and work). Interestingly, when I reflect on my personal life, I have actually done reasonably well managing the smaller details of things related to personal finance even though this is something that requires a somewhat large focus on details.

Well, now that I am re-thinking it, I haven't really done anything over the past two years with any of that. I isolated my biggest expenses, I cut them back fiercely, and then set everything up on autopay so I wasn't tasked with mailing out these things on a monthly basis. Now that I remember it, I do recall the great stress and anxiety all those responsibilities caused me the month after I bought my house. I remember the amazement I had that my mother had been able to do it for all those years with a checkbook without ever voicing a complaint.

I guess I am good at solving a problem once with great care (including attention to detail), but I lose almost all interest on any repeated attempts. If I was worried about my "natural ability" this should be a reminder and relief. It is also a sign I should consider careers in industries like software, where I can solve problems once and then have them replicated easily. I can program my thinking and wash my hands of a task.

I also wonder how this relates to my ENTP personality type and my innate disposition. As I have mentioned before, I generally like who I am and don't want to be someone else.

Maybe the following won't be enough to avoid meds and "cure" me, but hopefully they will put me in a better position if I eventually start them...

Interesting and on a slightly unrelated note, I was having a conversation with among other people a gay man and a black woman (who was also lesbian) and we broached the topic of monogamy. I quickly shared my own concerns and then mentioned how it was related to genetics (see section on gound vole). I said that I would happily change my genes because I didn't have any attachment to the trait (and not having it would make life easier). I then mentioned that in several hundred years we might be able to control gene expression and my own condition might be able to be cleared away by genetic modification. The question I posed was would they change their particular trait that has caused so much grief (being black or being gay). Little did I know I would be asking myself the same question again an hour later. It really helped me to see the "minority" perspective in a completely different light. It was a burden they didn't ask for, but was something they were handed. I guess my ADD is different because I actually like myself for many of the things it brings me and am reluctant to change myself just to make life easier.
______

Update: 6/28/2012

I actually ended up trying Strattera (I was not interested in stimulants) for about a month and a half. I had some modest side effects which I won't  mention (as they were likely psychosomatic (with the exception of increased heartrate [it went up by about 8-12 beats per minute] and don't want to bias anyone - but they were also part of the reason I quit), but I decided the medication wasn't a long term fix for me. HOWEVER, it was a very profound experience. The medication did exactly what it was supposed to do once we got the dosing right (80mg for me @ 160 lb). All of the scatter brained thoughts I had disappeared. I felt like Buddha. I am not sure if this is what other people experienceon a daily basis (as normal people) but it was quite amazing to me.I finally saw how noisy and chattery and jittery and all over the place I was. I remember talking with my friend who also has ADD and just being overwhelmed with the information she was spewing at me (now that my brain was different). I would not change that insight for anything. It has helped me to pause, to know when I am being confusing and too animated for others. In many situations, that awareness has given me the split second I need to pause before saying things. 

Yes, my mind is all over the place now, and initially it was a bit overwhelming to go back to the old me. I don't mind that now though. I am just glad to know how other people might perceive me and what and what it might be like for them to carry on a conversation with me. I am back to the old me, with no long-term impacts outside of a fresh perspective on things. 

Separately, it is also quite expensive without health insurance which was another big consideration. I might even retry it again if it becomes generic in a few years, which is planned.

I have gotten a good bit of google traffic to this post, so if you are struggling with self-diagnosis/self-help, below are some of my own internal battles and research.

I wish you peace and clarity.

My Related Posts:
Mouth Breathing and ADHD (seems to be a contributing factor)
Self Medicating (with nicotine)
Initial Thoughts (when I realized I wanted to try to "treat it")

Thursday, October 13, 2011

I usually laugh at these things...

... but there are always exceptions

Wednesday, October 12, 2011

ADD

I have been trying a variety of things for my ADD. Lately I have been
adjusting my dosing of coffee (a half cup seems to work best) but I
really don't like how it affects my sleeping patterns. Exercise seems
to work well, but I'm never motivated to be consistent. I am also
considering taking Adderall, but since it has similar effects it's
also probably going to result in the same thing. I also don't like how
coffee cuts me off from my emotions. I feel less when I drink it. I
feel disconnected from people. Productive, but disconnected. It's a
tradeoff. I'll have to calculate the benefits over time.
In any case, I don't think I'd want a daily rx, and the additive
properties, and subsequently higher dosing also concern me.
I'm also curious what sort of effects it will have on my personality.
I like who I am now and don't want to be someone else because of my
attention deficit problems.
I think I'm going to start video blogging. Writing takes too long and
isn't my natural form of communication and is easier for people to
absorb since I can communicate with more than words...

Monday, October 03, 2011

There is only one end and that is the end of life - everything else is simply to be continued....

Excerpts from the Meeting

Just doing some reading on Quakers and came across a poem by John Greenleaf Whittier

"No cool philosophy to teach
Its bland audacities of speech
To double-tasked idolaters
Themselves their gods and worshippers,
No pulpit hammered by the fist
Of loud-asserting dogmatist,
I know how well the fathers taught,
What work the later schoolmen wrought;
I reverence old time faith and men,
But God is near us now as then;
His force of love is still unspent,
His hate of sin as imminent;
And still the measure of our needs,
Outgrows the cramping bounds of creeds;
The manna gathered yesterday
Already savors of decay;"


"God should be most where man is least:
So, where is neither church nor priest,
And never rag nor form of creed
To clothe the nakedness of need,--
Where farmer folk in silence meet,--
I turn my bell-unsummoned feet;
I lay the critic's glass aside,
I tread upon my lettered pride,
And, lowest-seated, testify
To the oneness of humanity;
Confess the universal want,
And share whatever Heaven may grant.
He findeth not who seeks his own,
The soul is lost that's saved alone"

.....

Not everyone who says to me "Lord, Lord," will enter the kingdom of heaven; but he who does the will of my Father in heaven. Many will say to me on that day, "Lord, did we not prophesy in your name, and in your name cast out demons, and in your name perform many wonders?" and then I will declare to them, "I never knew you: Depart from me, you who practice wickedness."

This is, incidentally, the same passage where Jesus warns his followers to "judge a tree by its fruits," that is, not by their words or affirmations of some doctrinal orthodoxy. (7:15-19).

--------

The Religious Society of Friends is... "an alternative Christianity which emphasizes the personal experience of God in one's life. Quakers understand the necessity of first listening to God before working in the world. They affirm the equality of all people before God regardless of race, station in life, or sex and this belief leads them into a range of social concerns. Being "Children of the Light" they find recourse to violence intolerable. Quaker thought is both mystical (waiting upon God) and prophetic (speaking truth to power). Friends believe that God's revelation is still continuing, that God is not absent or unknowable but that we can find God ourselves and establish a living relationship thus being able to live in the world free from the burden and guilt of sin. It is the search for a closer relationship with God who is the Way. Religious knowledge, like the appreciation of beauty, is not attained by a logical process of thought but by experience and feeling. Quakers maintain that the teaching of Jesus is a practical method for the guidance of the world today, that religion is concerned with the whole of life, and that, beyond a certain point, definition becomes a limitation."

Maybe Neitzche was a Quaker....