elfs | Entries tagged with adhd

Someone on Twitter wrote:

“It’s the thought that counts.” This phrase is synonymous with gift giving, but have you thought about this phrase in a different way? It is always the thought that counts , meaning your thoughts and what you are thinking on a daily basis are what creates your reality.

Their point, as banal as it was, was that the recepient of a gift should always approach gift-giving in this fashion, always receive a gift as if the giver put “the thought” into it.

I think about this all the time, because as a person with a spectrum disorder (although my neurologist is quick to remind me that Interictal Syndrome is “technically not an ASD disorder, but the symptoms are the same”) I do not know how to give OR receive a gift.

If “the thought counts,” then I have received SO MANY gifts over the years where it was obvious the giver didn’t know me, didn’t think, and… didn’t care? I mean, maybe?

And as the giver, I don’t want to give a gift that they won’t like, won’t use, won’t read, and in a year will guiltily toss in the trash because “it was a gift from someone, but it’s really just clutter and I don’t have room anymore.” I just don’t have room in my home for any more tchotskes, well-meant “life changing books,” and small electronics I will never use, because like every nerd my specifications are narrow and specific. And every time I throw it away, that guilt comes back that I didn’t appreciate or understand, didn’t feel appreciated or understood, and damn but that fucking hurts.

Like every ADHD/ASD person with rejection sensitivty dysphoria, I’m super-sensitive to the awkwardness of a poorly given gift, and to the awkwardness of knowing a poorly given gift is a white elephant that makes the giver feel bad when you don’t use it, don’t like it enough to make it part of your life, and won’t prioritize keeping it, and makes the recipient feel bad because they didn’t feel seen or understood and ultimately have to toss the thing into the landfill, contributing to the ongoing crisis of a civilization that doesn’t really know how to deal with its waste.

I love everything about Christmas Season except for the duty of finding gifts. Hate everything about it. The act of mutual gift-giving, which we evolved to create understanding by sacrifice that mutually supports both the giver and reciever.

Because that’s what “gift giving” is: an evolved behavior between individuals and tribes that represented a worthwhile sacrifice in order to foster good-will on the part of the giver, and wanted or needed support on the part of the recipient that the giver was not obligated to give but, having done so, hopes to cement or maintain strong ties with the recipient.

In a world in which we (for some sad, awful definition of “we”) have enough food, water, shelter, and distraction, gift-giving is a ritualized demand that does nothing but prove you either do or don’t know the other person. And if you do, you’re either lucky, family… or really fuckin’ creepy.

Current Mood: anxious
Current Location: Antarctica (no, really!)

Sometimes I don't trust my extended ADHD diagnosis. I suspect my doc took a look at my intake essays and descriptions, saw the sex, the religious questioning, and all the writing, and said, "That's not ASD, that's Interictal Syndrome!"

The description of Interictal Syndrom is so vague as to be useless:

A distinct syndrome of interictal behavior changes occurs in many patients with temporal lobe epilepsy. These changes include alterations in sexual behavior, religiosity, and a tendency toward extensive, and in some cases compulsive, writing and drawing.

Some interictal patients don't even have seizures... they just have a constant, ongoing storm in a temporal lobe that causes those "symptoms." Despite their low resolution, PET scans clearly show such a storm in my left temporal lobe (the "ADHD" one) instead of the right (the "sex and whatever" one).

I suspect the extended diagnosis is a failure. He was an older man and burdened with prejudices. He's retired now. I don't know if I want a re-diagnosis; I get to have something in common with my wife (We're both epileptics now? Cool!) and there's something ticklishly delightful about having an "obscure" diagnosis, especially one with the promise of so much havoc behind it.

Then I remember that TempleOS's Terry Davis was THE poster boy for Interictal syndrome, and maybe I rethink that. Terry was a sad victim of his syndrome. He was a brilliant programmer who wrote an interesting DOS-shell, then claimed it had been dictated by God, was viciously racist and sexist and hated sex itself in all its forms, and harassed anyone who told him TempleOS wasn't that great.

But I'm clearly NOT Terry Davis, and the general diagnosis is good enough to give me access to a psychiatric neurologist and the medications I need to keep a job I actually like and that actually pays well, and doesn't (quite so often) drive my wife crazy.

Current Mood: blah
Current Music: Eat Static, Sucker

It has been fourteen days since I was last allowed to use my ADHD meds. I reassured the staff that I was still “somewhat functional” without them, and the sheer volume of text output over the past two weeks, plus writing TCDump and helping someone fix their Surface Pro 6 Camera Driver the old-skool way, shows pretty conclusively that I wasn’t kidding about the “somewhat functional” part.

I still feel pretty low. I couldn’t possibly work on anything big, like Scarlett or BFDLang, with my brain this addled with the drugs and the pain. Especially the pain. Every swallow is like being stabbed in the throat with a stiletto.

But it’s been interesting working without the medication. I find, oddly enough, that I have much more verbal output– my hypergraphia is in full swing now that I’m not on the medication. But it’s also very scattershot.

I use an older Unix window manager, one with “workspaces,” which is basically a full screen in which a single project can be held. You switch between them the way you do on a TV remote control– press an activate button (in my case, CTRL + ALT) and then use the Left or Right keys to go “up” or “down” a channel. And apparently, I must have learned to use this kind of manager years before I got treated, because it allows me to “channel surf” multiple projects at once, working a little on one until I get distracted, then going to another, then another. (In the course of writing this paragraph alone, I’ve checked Twitter, had a nurse come and give me vitamins, looked at my email, reviewed my “take” from my audio recorder last night, and called my mother.) Every once in a while I’ll just flip through the channels and go, “Oh, yeah, that. I should finish that.”

It doesn’t make for deep programming. I couldn’t concentrate for hours on an algorithm until I break it down and understand it deeply. Without my meds I’d never be capable of software architecture or the deeper mathematics that my current level of skill and training require. But it’s interesting, and it’s a bit like being The Old Elf, the guy who wrote a lot of stuff every day, because his brain had a lot to say.

Current Mood: curious
Current Location: Hospitalized

One of the symptoms of my ADHD/interictal syndrome/whatever the fuck this is has reared its head in my learning how to tie people up.

When I was a small child, one of the tests they did to determine my ADHD was a orientation test, and it went something like this:

“You are facing north. Turn left, turn right. What direction are you facing?”

“North.”

“You are facing South. Turn left. Left again. What direction are you facing?”

“North.”.

“Okay. You are facing north. Turn left. What direction are you facing?”

“East.”

You are facing north. Turn right. Turn right. Turn left. What direction are you facing?"

“East.”

Essentially, my north and south were always correct. My east and west were always random. And they couldn’t figure out why. But I knew why: I didn’t know what direction “left” or “right” was.

But I knew that if I was consistent, then “left” always meant turn their same way. “Right” meant, for that particular session, turn the opposite way.

Every time I started, when they said turn left or turn right, I could easily have gone clockwise or counterclockwise. At random. Because I had ADHD, I couldn’t pay attention to directions like that.

I remember when I was learning to tie my shoes, my mother had such a trial teaching me which direction to wrap the string around my thumb to make the loop for the bow. I could never know if I was going up over the the thumb or below the thumb. Of course, every kid was taught to go up and around the thumb, not down and around the thumb, and with enough effort I eventually memorized “tie up, tie up.”

I have rediscovered this problem while practicing my Shibari knots because I can’t remember which direction to make the loop for the final tie to make the cuff for a single column. I do it clockwise or counterclockwise at random. That information doesn’t stick in my brain.

I’m going to have to repeat it a lot until it does stick.

The special irony of the shoelace anecdote is that it has long been known that going under the thumb while making your loop actually creates a stronger and more balanced knot that is less likely to come undone during the course of the day.

Here's a TED Talk (eyerolls are acceptable, but it's only three minutes long) documenting how the "going under" version of the knot is better:

Watch on YouTube

Current Mood: amused
Current Location: Hospitalized

This has nothing to do with the video game. Just so you know.

I don’t know if it’s my ADHD or whatever is going on inside my brain, but I’ve discovered a weird phenomenon with my learning ability. When it comes to explicitly physical skills such as juggling, drawing, or martial arts, I know exactly what day that skill is going to fade.

If you’re familiar with learning techniques, the two most powerful known are related: spaced repetition and active recall. Spaced repetition is the notion that a bit of knowledge that you’ve learned is reinforced if you’re reminded of it as close to the moment when your brain is about to forget it as possible. It’s a signal to your learning system that, no really, that bit of knowledge needs to stay around and be available for recall. Active recall is the process of making the method by which that reminder is brought to your attention demanding in a way that makes you think hard about the answer, wrapping it in layers of attention that your brain now credits with importance, giving the knowledge memorized a higher priority.

These techniques work for me when it comes to knowledge work. But when it comes to physical skills, the act of building “muscle memory” is very real and, to me, seems to be different from, well, memory memory.

So, the weird part is this: when I’m trying to learn a physical skill, if I do it for a while and then leave off for a few days, there comes a day when, as I wake up, I’m very aware that if I don’t practice today that skill is going to be gone. I’ll be back to the beginning, and have to go through the practice all over again.

I call this phenomenon Half-Life Day, because my embodiment of that skill has a half-life, and that day is the day that skill will fade away so effectively I won’t be able to recover it.

Today, I spent a half-hour drawing, because I knew that if I didn’t, the smallest steps I’ve taken toward recovering my drawing skills were going to be gone. I feel pretty good about that.

But I was wondering if other people have reached that point, where they know that a skillset is about to die, and how they deal with their own half-life days.

Current Mood: curious
Current Music: Seba, Snow

I discovered something important this past week while I was out camping in the woods. I had no Internet and no network connectivity. What I did have was a folder full of math papers and a notebook full of story ideas, and while Omaha and I did spend a lot of time either hiking, cooking, swimming, or playing card games, I also spent a lot of time just reading. Mostly trashy stuff, but reading.

It’s also important to know, perhaps, that I didn’t take any of my ADHD meds with me on this trip. I didn’t think I’d need them. And you know what?

I didn’t.

I’m starting to think that the kind ADHD described by normal people, that is, the ADHD which impacts the witnesses and not the person with the condition is, like depression, triggered by the environment in which we live. That its utility, in moments of hyperfocus and manic productivity, is swamped and broken by the regimentation of modern schooling and the conflicting multifaceted demands of office work.

I came up with four great story plots. I also grokked something deep and important about the fundamental theory of computation, something that links the Kleene Algebra to everything from regular expressions (where they’re most commonly used) to the basic descriptions of what a programming language is. (I could hyperfocus geekily on this right now, but I’ve learned not to.)

Omaha and I agreed not to discuss the world while we were out. It was impossible to keep that promise completely; sometimes, while driving from the campsite to an active trailhead we’d pass through a zone with radio and snatches of what was going on in the world would filter into my imagination. I don’t know about Omaha, she’s the event-driven, extrovert type; but I learned just how long it takes to get my imagination back into the groove of whatever it was I wanted most to think about.

The answer, sometimes, was all day. I’d have to go read something ridiculous (I read a lot of Lovecraft) just to flush all the world’s anxieties back out of my head.

I’m currently riding high on a week of being well-rested as well as alcohol and drug (even prescription drug) free, at least for the cognitive drugs. (I still took my statin and allergy meds, duh.) I gave my future self a list of to-dos that, so far, future self has agreed are sensible and workable. Some are more challenging than others, and today has been little more than “get re-aligned with all projects, both professional and personal, after being off-line for 9 days,” so we’ll see how far I get on any of them for realz of course.

This is a thing I have to remember, this is the thing all those “do your big thing first thing in the morning before anything else” stories are about: you do your best work when your mind is uncluttered, and the one thing the black slab in your pocket and the email queue on your desk want to do, the one thing they want, is to grab your attention for their purposes not yours, and if you have any intellectual life at all, there are a lot of processes out there vying for your attention.

They create the very clutter they’re trying to break through and, in the process, they deny you your rightful control over your own attention.

Current Mood: thoughtful
Current Music: Azula's signature chime

For my birthday, I bought myself a new laptop and a couple of fun peripherals. The peripherals were mostly to round out and survive the coming wireless future, when there are no more USB connectors on our devices and everything has to talk over Bluetooth. One of the toys I bought myself was a Muse brainwave-sensing headband.

I have no idea if this thing is even vaguely legit. I've seen quite a few articles about how the sensors are legit, if inaccurate, and they only show a mash-up of a variety of electrical signals whizzing past at any given moment, but it's hard to know.

In any event, there are a few things I've noticed. The first is that the left temporal lobe sensor is always the hardest to calibrate. That's hardly surprising since my left temporal lobe is where the ADHD "storm" is happening; on the sorts of scans that track glucose consumption, that corner of my brain is constantly lit up like Iron Maiden night at the laser lightshow.

Since I have ADHD I take Dextrostat, which is basically a medical amphetamine. Omaha likes it when I take my meds because she says I'm calmer and easier to track when I'm on it— which is actually a better sign that it's really ADHD than any other test, since people without ADHD get jittery and easily distractable when on Dex.

So I tried an experiment. I tried using the Muse with, and without, the Dex. The Muse claims to track "calmness," the time when your brain wave levels are low and relatively harmonious. They rate your brain as "active," "neutral," or "calm," and give you a score: the number of seconds you spend "neutral" plus 3⨯ seconds spend "calm." While not on Dex, in a ten minute session I scored 385 points and wasn't "calm" enough to get a bonus; while on Dex, I scored 935 points and 5 times was "calm" for long enough to get a bonus.

That's just a pair of data points and therefore totally anecdotal. (The plural of anecdote, by the way, is data.) But it was fun, and kinda a neat way to play with the toy.

Current Mood: amused

My morning meditation was a little weird today.

Okay, so, probably more than you want to know, but I have three or four different kinds of meditation that I do, not all of them on the same day, although if I do manage three out of four then it's a very good day as far as I'm concerned.

The longest one is a straight-up breath meditation as practiced by just about every spiritual tradition in the world. It's a self-discipline exercise, meant to strengthen the executive network (the part of your brain that helps you concentrate on a given task) and to reinforce the role of mindfulness and attention in your life. What you pay attention to is what gets done and what gets valued. Breath meditation trains you to pay attention to paying attention, which is actually a very useful skill. Various traditions build off that skill, but it's definitely the first skill, and everyone desires it.

Today, due to a scheduling issue, I took my ADHD medication just minutes before going into the breath meditation— and could tell exactly when the medication took hold.

So, my ADHD is the result of an overactive left temporal lobe of my brain. It puts out a lot of noise that constantly threatens to distract me. The noise is about other things I like to do, like write and code and such, but it's still noise that distracts me from what I'm doing. Everyone has a noisy brain; I'm just much more susceptible to being distracted by it than most people because it's so much more noisy than average.

Most ADHD medications are stimulants. They work not by quieting the noisy part, but by giving the rest of the brain a bit of a kick that enables it to overwhelm and mask the noisemaker. That's exactly what it felt like; within seconds my usually drifty mind went from a noisy place to much quieter. I still drifted from time to time in concentrating on my breath, but it was for much shorter periods of time and I was much more capable of dragging my thoughts back to the task at hand, building up my mindfulness.

It felt a lot like I was cheating. "Doping for meditation" sounds ridiculous, and I should probably figure out just what the differences are. But it was such a profoundly notable effect, it might be worth investigating further.

Current Mood: curious

Usually, JStor isn't a place where I have much truck, but Kate Bielamowicz's America's Workforce Runs On Narcotic Stimulants hits me where I live. She keeps using the term "narcotic," and I'm not sure what she means by it: "narcotic" has two meanings, the first of which means not prescribed, the second of which means opiate-related. Since she's describing prescription stimulants, I can only conclude that her use of the term narcotic is a perjorative: she's trying to link the readers' minds an unwarranted connection between stimulant overprescription and the current opiod addiction crisis, which is claiming a lot of lives.

I can't speak for people who take amphetamines recreationally, or for those who get it off-label.

But I take Dextroamphetamine IR for my ADHD. I have fought my entire freakin' life with this condition, and to say it doesn't occur in adults is to deny my lived experience. I take 5mg, once a day, with breakfast, and it actually allows me to function as a human being. Since I've started taking it, I have actually started to complete a number of important projects that have languished for years.

I have a prescription. It's hard to get that prescription filled; it's a Class-I substance, which means I have to drive to the doctor, have a check-in, get a hand-written prescription, drive to the pharmacy, and wait for them to get it in. I can't fax it, I can't have it called in. I have to be present at each and every step of the transaction and present ID for it.

The number one effect of it has been the alleviation of frustration. I'm not longer constantly mad at myself for being a failure, for being unable to finish things, for being so damned incapable of calming down my hyperactive, overly talkative, ooooh-shiny! brain.

So don't make me angry. I'm pretty pathetic when I'm angry. And Bielamowicz's article seems determined to try and stir up a new moral scare, one that will make me angry.

Current Mood: annoyed
Crossposts: http://elfs.livejournal.com/1606957.html

The only book at the local library for adults with ADHD was entitled The Queen of Distraction, a book entirely for and about women with ADHD. I picked it up anyway. Good list-making tips are good no matter what your gender.

But the section on romance really (and I mean really) bugged me. Because the author wa, y'know, cool and all with the idea that hyperactives might not want to settle down, but instead spend a lifetime of moving from relationship to relationship as boredom settled in, but inattentives might well want a "real" relationship. You know, one that lasted.

She really does a fantastic job of capturing the anxiety of ADHD/I on a date. I can't stop looking at that flickering TV in the bar. He probably think I'm an idiot because I can't keep up in conversation or find the right words. Do I look okay? Am I talking enough? Too much? But the thing is, nowhere in this long (and duplicated) tale of "getting serious" is polyamory ever really discussed. I mean, seriously, if you're the sort who wants both a stable relationship and lots of lovers, have both goddamit. Just do it with everyone's consent and compassion.

There's an entire goddamn chapter on clothes and laundry. Part of it's excellent: the anxiety of buying and wearing clothes for someone with ADHD is well-written, but the whole laundry thing is so detailed it's closer to an autism spectrum disorder how-to than anything.

It's such a mix. It's like, there's ADHD, and if you want to live the most boring, middle-class, white-bread life ever, this is how you look like you're doing it while managing your spinning brain.

Current Mood: amused
Crossposts: http://elfs.livejournal.com/1600455.html

The comic there on the left appears in many different places on the Internet, and in several different forms. It's a commentary on Ritalin or Adderall or any number of ADHD medications that supposedly turn children into good little drones or workers. The sympathy it's meant to evoke for Calvin & Hobbes is strong, and when I first saw I had the same impression of pathos most people do.

Except that I have wrestled with ADHD most of my life, and recently I decided to do something about it. I went to a psychiatrist who, after a five-hour interview and multiple hours of testing, prescribed for me an older ADHD medication, dextrostat, and I have to say that I can't look at that comic with the same sense of identity I used to.

It's Sunday as I write this, and like every Sunday there are the chores. You know that phenomenon known as "structured procrastination?" I have something similar: structured distraction. I would deliberately choose three different tasks, and round-robin them. As the "activation energy" for one task faded away and I was tempted to another, I would have the others there at hand, visible and triggering, so that I was doing something useful with my time most of the time. The context switching costs for this technique have always been nasty, but at least they kept me on task, and since I'm aware of what's going on, I've been able to route around this annoying dysfunction and become a good programmer who produces fine and useful code products.

As I said, there were chores. I had a list of kitchen cleanup and weekly food prep times, which I had made before taking my meds. As I was doing each chore I kept glancing at my phone. "Nah, gotta finish this first." A little voice in the back of my brain was yelling, "What do you mean? Twitter is right there!" But I ignored it and kept on doing. The kitchen only took about 45 minutes total. Only when every line item on the list that involved being in the kitchen was finished did I allow myself to sit down and write this little essay.

(There are other line items, but they involve either going out, or are dependent upon other people whose time I can only ask for.)

Since the tasks involve only my hands, I did allow myself to dictate the first draft into my personal voice recorder. This told me two things: one, the dextrostat doesn't wreck my ability to multitask, only my ability to do so wastefully and two, it doesn't at all wreck my creative faculties.

I feel for Calvin. I do. My parents never medicated me as a child; this left me to fend for myself as best I could, with the most well-meaning people poorly informed with the resources of the mid-20th century trying to help. Forcing medication like that on a child who's succeeding is a terrible thing; using it to manage a troubling kid seems wrong to me. Any medication that would blot Hobbes from Calvin's universe just feels like evil.

Yet for an adult, things are different. Now I know how to ask my Hobbeses (and I have rather a lot, being a writer and all) to be patient with me. I don't tell them to go away, and they do come back. Even while the medication is active, I can ask them to come 'round and help me with their stories. At those times, my muses and I have conversations, not shouting matches.

For me, it's a goddamned miracle. Oh, this is what it feels like to be focused and productive! Low-dose Dextrostat has given me the voluntary control over my attention span I never knew I was missing without breaking anything else: not my creativity, not my sense of self, not my emotional range.

ADHD is real, and no amount of cognitive behavioral therapy, meditation, or nutritional "balancing" has ever made a goddamned difference in my life. Timers and notebooks have been all I've had. Ever since my first Palm pilot up to my new and shiny Android watch, they've been fantastic tools, but this is different. If you're an adult, and you've been wrestling with a mind that won't let you do and be, seriously, think about seeing a doctor and getting it treated.