Archive for the ‘ADD’ Category

Of the many things which anger me, there is one which has most consistently brought out the Billy Liar-like angry daydreams that have been part of my life for as long as I can remember. It takes a number of forms, and I seem to come across one of them at least once a month without first getting on to the subject of neuro-developmental conditions or “SEN” myself. Yes yes, your wife worked for the council and knows for a fact that doctors cannot help but give out Ritalin to demanding mothers of egregious boys. Ok, so you read in the Daily Mail that ten minutes in a park three times an month cures ADHD. Great, so running does much the same. Wonderful, so your grasp of both history and medicine is so good that you know no such disorder as ADHD existed years ago? Oh, so you heard somewhere that Ritalin makes zombies of children?

Right now, I take 60mg of Strattera daily. I would take more. Until the summer, and for a year, I took around the same quantity of Ritalin. Before that? Well, before that I didn’t function. If all the kinds of thoughts it is possible to have were thought of lengths and thicknesses of taut wire vibrating at a given pitch when struck, my head was like a piano falling down a flight of stairs. I could go on to describe more; to describe the many ways that, directly and indirectly, added up to a situation where it would be hard to state I was living at all. I will not do that here because I don’t feel much like justifying myself to my potential detractors on this issue. I know who they are too well for that.

They can be psychiatrists I go to for help. They can be friends and family members. They can be co-workers, customers. They can, of course, be people on the internet who IMHO their way through those peremptory statements you find out there day after day, knowing exactly how perfunctorily they have been arrived at but being somehow fatigued by them all the same.

In a previous life I worked with kids with neuro-developmental disorders. I guess I have worked with hundreds who were on Ritalin, perhaps the favourite punchbag of idle journos everywhere; the scapegoat indeed of idle thinkers everywhere, of those who are disgruntled in some vague and rather hackneyed manner, most often after a fashion that is not only not radical, but manifestly operates in the interests of all contemporary elites but, perhaps, those in the psycho-pharmacological industry.

I have not generally been on the side of big pharma. I first became interested in the way scientific research is skewed by the power of big pharma when I read about David Healy’s job offer at the University of Toronto being turned down because of his stance on SSRI’s when I was at university in around 2000. Following that, I became very critical indeed of the way our understanding of psychiatric disorders is constructed by psycho-pharmacologists and representatives of big pharma. I could go into this and some other time, I am sure I will. Without making any effort to do so, in fact, I have just now brought to mind at least two instances where this very question has been of central importance in a work of fiction I have been writing, a novel that was more important than anything on earth to me for a long stretch of my life (a year or more in both cases¹).

What is important, here, is that I took an SSRI at university back in around 2000 and though it was a rough time of my life, and one I don’t well recall, it may have helped. Though the chronology of that period of my life remains sketchy to me, it seems likely that it did. Neither this fact nor my current usage of Strattera makes me into some kind of evangelist for an exclusively psycho-pharmacological approach to mental disorders. Far from it. I believe that psych-pharmacology is one part of the picture, and, in many, perhaps most cases, not the largest part. It certainly does not mean that I subscribe to some kind of chemical-imbalance take on mental health problems. In fact, I think that the most likely origin of my own problems, and of those of a majority or, at the least, a significant minority of those kids I used to work with, is metabolic and/or immunological in origin. Nutrition and lifestyle are the therapies I spend most of that part of my time and energy I can devote to thinking on neuro-developmental conditions working to further. I have talked to medicated friends recently about referring themselves to people who provide talking cures, and have given them names. I have supported other friends in reducing their medication. Still, meds have their part to play; they can, if nothing else, provide a short-to-medium-term turn-around that can help people to function in order to start putting those elements of their lives into place. Quite apart from that, nobody needs to tell me how much discipline it takes to implement my own favoured therapies and strategies day to day.

What I am doing right now is the best solution I have yet found in many years of research that I conducted in as thoroughgoing a fashion as I have been able over the more than ten years since university. This is the best I have managed with an army-level of discipline, a “brain the size of a planet” and a great deal of experience working in the field where quite aside from having regular training sessions, I was able to make observations and draw conclusions. I don’t need people who I know to have less than a simple English Wikipedia entry’s knowledge of any one of these issues at the very best, telling me their opinion on whether I should take such a decision as I have.

Believe me, if there were a way to do away with the medication that is one part of my several pronged approach right now, I would have done so. I am not a weak man. I am not an unresourceful man. Neither am I averse to taking a difficult path, if that is what it would be. My budget is tight, is stretched already with the money I have to spend on decent food, and I spend perhaps one half of my rent on getting medication right now. All else being equal, doing away with meds would make things much easier.

The fact is, though, that all things are not equal. If you think otherwise, you probably don’t know what you are talking about. Even if you have some fraction of an inkling of one of the subjects I have had to take on these last years, you ain’t me and you cannot make decisions for me. Back off.

I haven’t written here for some time and though I am looking into pod-casting right now, I might not do so again for some time. Today I had to write something because I came across a post on Twitter in which  wrote about her experiences with anxiety and depression. No stranger to abuse on the internet, she knew she would be slammed for it and that she was giving ammo to her detractors who would no doubt take the opportunity to call her crazy, neurotic, and all those other names we get called for breaching the taboo of talking about our mental health. Still, the abuse she got for speaking out in favour of SSRIs came as a surprise to her. Worse, she was disappointed, as many of us have been, by the people who slammed her for taking the choices she had, and for telling others that medication might help them.

A pox on the houses of anybody who slammed her for doing what she did today. It took guts. And a pox on the houses of anybody who would prevent anybody looking into their options for help when things become too much for them. Medication is one route towards a better life for many hundreds of thousands of people, and at the time of need, it doesn’t matter a damn what caused the problems they have, whether it may be the industrialisation of food, the presence of industrial pollutants in our environment or other civilisational stressors; the only thing that matters is getting help.

¹ I am talking here about novels I worked on under the names Call Them Soldiers and The Thaw, in case I should refer to them in the future or indeed, have in the past.

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The last few days have been as bad as any I have known for a very long time. I rang in sick today. In fact, I rang in sick and then, failing to get through, I wrote an e-mail. I expect to hear about that, be dressed down for it and/or sacked. I imagine I will be told that it is unprofessional. Maybe they will have read something that I have posted to social media. Perhaps they will simply have had enough of my recalcitrance, my periodic recriminatory e-mails, my being so stubborn when everybody else knows to be so pliable. But then none of this is anything new. I often expect to be sacked. I have changed jobs more than most and though I have walked out of places, I have not yet been sacked or indeed disciplined as far as I can recall. It is just that I have never not been a square peg in a round hole. I have never found it easy to simply knuckle down and do what I am told if I don’t believe in what I am supposed to be doing.

I have mentioned before that I have AD(H)D. I have mentioned before that I have asperger’s syndrome. Usually such posts last out there a couple of days, if that, attract a couple of more or less accidental visitors before I take them down. I have 400 followers on Twitter but I have perhaps twice tweeted a link to a blog post. What I have written here has most often been a kind of solipsistic venting. Posts, that is, have usually taken the form of the kind of off-loading I would prefer to happen face to face, in a pub or, better, a cafe; during a run; even those that pour out of you somewhere, when you close a car door and get moving, step out on a hike, walk out into the smoking area: the kind of chat you have with somebody you trust. Probably, they are the kind of chats you don’t even need when you have somebody around you can have them with. Blogs, for me, have occasionally, when they mean anything at all, taken the place of friends and acquaintances who get what I am about, a distributed network of potential sympathisers, confidantes. As I write, it doesn’t matter if they are there. I would almost prefer nobody to hear what I am saying; it matters that they might hear, they might get it, they might have been waiting for somebody, finally, to say the same thing.

I have closed up over the years, got my guard up high, began to throw in a tapper jab in now and again when I am not sure whether somebody is thinking about getting on my case. I would say I learned to ‘trust, but verify’, but I put up the threshold for verification so high nobody can pass it without getting close enough to show me their true selves, and I don’t let them do that if I don’t trust them.

The conditions named above lead can lead to reclusive dispositions in and of themselves. The degree to which the natural disposition of those with Asperger’s syndrome is anti-social is contestable – Tony Attwood is balanced, it seems to me, in alluding to both the difficulty neurotypicals experience in empathising with their Aspergic peers and also the propensity Aspies indeed have for certain kinds of socialising, mixing well with others like themselves, and those who are essentially more logical and scientifically-minded than most but who do not possess the requisite core traits of asperger’s, or demonstrate those more peripheral traits in sufficient quantity to justify diagnosis. Nonetheless, if the disproportionate incidence of children with Asperger’s in Silicon valley and its equivalents suggests that there is indeed some kind of sociologically significant aspergic socialising going on somewhere, it remains the case that there are a significant minority of Aspergics, both diagnosed and otherwise, whose one truly mastered facial expression is “fuck all y’all” and who don’t willingly speak to anybody without a gaming headset on and a virtual firearm. AD(H)D is the opposite case: it is frequently assumed that those with ADD/ADHD are very sociable, perhaps too sociable. Indeed, often they may be. If those with ADHD are able to slot into a dependable social circle – a sports team, perhaps, or a team associated with a relatively ADHD-friendly job – it may be throwing themselves into the social world that they need over and over to provide the stimulation they need. But here is one of those  examples where a given condition may lead to two or more experiencial and behavioural manifestations that are not merely discrete, but in fact perfect opposites. People with this condition may find themselves at one or the other side of a notional normal distribution graph of sociability and struggle to scale it.

Edward M. Hallowell, M.D. and John J. Ratey, M.D.:

ADD can interfere with one’s interpersonal life just as dramatically as it does with one’s academic or job performance. To make friends, you have to be able to pay attention. To get along in a group, you have to be able to follow what is being said in the group. Social cues are often subtle: the narrowing of the eyes, the raising of eyebrows, a slight change in tone of voice, a tilting of the head… a lapse in social awareness due to the distractibiliy or impulsivity of ADD can preclude acceptance by a group or deny understanding from a friend.

All true (though I am not certain the degree to which the social cues examples used above can be objectively ascribed to ADD qua ADD). And indeed it goes deeper. People with ADHD struggle to maintain meaningful loving relationships almost as much as those with asperger’s. Additionally, too, the fact that they are underemployed, that they may move around a lot, lose jobs and be out of work for long stretches, may mean that they are socially excluded. And whether or not we accept that those with asperger’s need less in the way of social contact than neurotypicals, we can agree that, whatever the deficits in social function experienced by those with ADD, they don’t desire social contact any less than others. This leads to their experiencing hugely disproportionate rates of depression.

For me, I suspect the principle cause is different from those adumbrated above, though I can’t be sure that the symptoms of ADD and Asperger’s, or indeed the aetiology of the disorders themselves can be meaningfully unravelled and independently examined in this way. I sometimes thing that they, and other neurodevelopmental disorders which appear to be linked in terms of predispositions which appear to be genetic, may be discrete manifestations of a self-similar underlying cause, perhaps a metabolic anomaly. Whatever the truth of this, the main problem I experience as limiting my scope for social life is not my unarguable inability to work out what you people are thinking or my once-regular incapacity to pay mind to whatever it is you are banging on about, nor even the iron law that seems, wherever I go, to guarantee that all but the peaks of the conversation of 19/20ths of those I meet don’t so much as tickle the underside of my vertiginous boredom threshold.

It is that I have to do so much to keep my symptoms down to near-manageable levels. This here now is the paragraph where I will stall, where I will fail to complete this post. This is precisely where it will grind me down. Where merely thinking about taking on all of the misconceptions, the sneers, the ignorant dismissals wears down what energy and focus I have until I am sent on some reactive escapade, needing to leave the flat, get out and distract myself from all of it.

And so here I am several hours later. I have done a little debugging and, fingers crossed, it has worked. We’ll get on to that. In the interim, though, I have mentioned food before as a major problem of mine before now. I have worried, indeed, that it would see me leave Prague. Perhaps it still will. It was a contributory factor in a simply awful week spent out in the hills here back at the end of the winter and there is not a day it does not hugely complicate.

I was thought an idiot in the conveyor car wash I worked at when I was 17, 18. I hadn’t often been considered an idiot at school and I am rarely considered an idiot now. There was no good reason to have been considered an idiot back then either. I was reading the broadsheets in that office, worked my way through the culture section of the Observer, took in books to read from the library and, when I was worried about the petrol fumes, read up on PM10s in my brother’s cast off copies of the New Scientist. Still and all, the manager was a class A prick and for all that was going on inside my head, none of it was being expressed.

“You’ve got the constitution of an ox,” he used to say. I used to stuff myself with sweets, Ginsters pasties (MMMM, Ginsters Pasties!) and flapjacks. For years I lived for sweets. Sugar was a compulsion. Had been for years. On a trip to Spain when I was six or seven years old, I would empty the packets of sugar from the tea into my mouth. In my first years of secondary school, I would hide midnight snacks in my room and wait up till midnight to listen to Ian Perry’s Midnight Line.

It was at university I got looking into it the more. Cooking may initially have been a procrastination exercise. I used to cook for the whole house, regularly. I would pick up cookery books and experiment with different styles of cooking. I got pretty good at Chinese, did a few nice Italian dishes, some traditional British stuff. Ended up paying for most of it as I recall. Later though, when I was doing a lot of reading into my problems – which were as obvious then as they have ever been – I got into nutrition in a big way.

The first book, spotted on a shelf of the Student Support Centre woman who worked there part time while doing some postgrad research on Byron, was Potatoes Not Prozac. I’ll not give a link. It was pseudo scientific and not the place I would recommend somebody to start. Start me it did, though, and since even a stopped clock is right twice a day, it gave me a couple of decent leads despite its flaws.

At first, I switched to brown bread and cut out the highly refined carbohydrates. Since I used to eat a lot of chocolate and likely had some nutrition-free cereals for breakfast, this was a big change in itself.

Other changes came piecemeal, and always with a fight and multiple backslides that have continued ever since. Nor can I remember now exactly what had the most effect. I got my degree, but came out the other side of it as chaotic as I went in with a mental microclimate that threw around ideas, priorities, impulses and interests like Wizard of Oz Tornado threw around houses and farm animals. I kept on creeping forward with it, but since learning what worked and what doesn’t was a slow process and since I have always said that if I had the organisational capacity to follow the diet, I wouldn’t need it, it was a constant battle marked by retreats and significant defeats as well as progress.

 

I’ll go into it a little more. There is a lot to it. And I have not yet touched on what has made me ill this time around. But it has been a battle getting this down, and I’ve done enough fighting with my head these past few days, so I will break this into sections.

 

 

 

 

 

I’ve lost my routine, and routines are important to me. When I’m between things I am agitated, restless, irritable, broody, and can settle into nothing. Mornings, afternoons and evenings jarringly pass with the motions of a learner’s kangerooing car, shaped by nothing but pacings from one activity to another, none of which lessens the edginess or the urgency of feeling that I need to be doing something else.

Waking this morning I wanted to run. A thermos of green tea by my bed, I drank and read for a while, but, tired from being unable to sleep last night, I found myself flitting from one book to another, and, what was more destabilising, between these and Twitter. I couldn’t find the banana I had put aside for breakfast last night which, silly as it sounds, threw me further. I had intended to read for a while, drink tea, eat breakfast, and, when I was out of tea, get on my running shoes and go for a run. (more…)

I’m going to try and write a quick, more sober, look at things today, avoiding some of the histrionics that come out of me the times I am drawn to purge myself of some of the bile, bitterness, resentments, frustrations, anger and self-hatred that come up from time to time negotiating life as an intelligent, creative, high functioning autistic.

I have been back from Prague for almost a month now. It has gone quickly. In that time I have adjusted not at all to being back. I have settled not at all. I have thrown myself into one thing and another, trying to build a kind of structure around me. I have, to this end, written a lot of pieces for a rather quixotic application for a position on a respected left wing political journal. I have read a fair amount of Czech, trying to improve my level. I have met up with a girl around here who wants to work on some songs, me playing guitar, she singing.

(more…)