Monday, October 17, 2011

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.

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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.
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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.
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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")

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