The Dark Side of ADD Meds

My three weeks of travel (Dallas to Jacksonville to Miami to Houston to NYC to Syracuse to Poughkeepsie) which included climate changes from balmy and humid to driving through a snowstorm in frigid 20-degree temperatures in a car with no working heat has finally caught up with me. I lost my voice completely after my last training on Friday, have been in bed since Friday evening, and I don't think I'll be able to write my planned reflection this week.

The NY Times published a heart-breaking piece on the tragic suicide of a young man who became addicted to ADD meds. The article suggests - and his poor parents believe - that he was misdiagnosed after he faked his way through the diagnostic test, and the doctors failed to conduct the full life-history evaluation that many practitioners recommend. He, like an alarming number of college students, started abusing ADD meds in college to boost concentration to enhance school performance.

The article paints a really tragic picture of a bright, promising life that went off the rails because of a drug that's meant to help those with who struggle with distraction and inability to control their attention. What the article doesn't do is question why people who actually don't have the kind if brain chemistry the meds were intended for feel the need to use them. What is it about our society, our education system, and our modern world that would cause someone who is "normal" to turn to drugs to be successful? More importantly, what does it say about the way our society has evolved that a significant percentage of our child and adult population are now being prescribed medications so they can be "normal"?

I've been planning to write something on an alternative way of framing ADD - not as a disorder, but rather as identification of individuals who have traits that were important and useful to society historically, but who increasingly have a hard time fitting into the fast-paced, regimented and demanding modern world we now live in.

Until I get to writing that piece, I really think anyone who has any interest in ADD, medication, and mental healthcare issues should read the Times article. And if you're someone who uses stimulants to boost performance in school or work, whether you have a diagnosis or not, think for a minute about what it says about our world that some people are medicating - and in some cases abusing medication - just to do what they think is expected of them.

Sticking Together

While on this last business trip, I had the opportunity to meet up with an old family friend. His fourteen year-old son was also recently diagnosed with ADHD, and he and his wife have really been struggling with how to support him. Their son - let's call him Jeff - has had a rough time the last couple of years in school. The diagnosis, instead of being a relief and a moment of rebirth as it was for me, hit him pretty hard. I offered to hang out with Jeff to see if maybe I could help. At the very least, he'd finally have a chance to talk to someone else with the same kind of brain wiring.

I can't imagine how hard it must be to be fourteen, just starting high school and just wanting to fit in, and be told that you have a "disorder". Freshman year of high school was tough enough as it is. Jeff has focused a lot of his energy on football - not surprising, considering exercise and sports are a common form of self-treatment that undiagnosed ADDers gravitate towards. He has insomnia, which causes a lot of stress, because he's tired a lot of the time, is late to school a lot, and because - in his quest to get bigger and stronger for football - Jeff has done the research and knows that he needs a lot of sleep at this stage in is life as he goes through puberty. He's worried that his inability to sleep (also a common trait) is going to doom him to being too scrawny to be a good football player.

Over huge Texas-sized steaks, I told Jeff about my own experience in high school (it may surprise you to know that I played football my Freshman year. I wasn't any good - not aggressive enough, apparently.) I talked about a bunch of the tricks I had developed over the years to deal with life, both pre- and post-diagnosis. When I told him I often feel at the end of the day thay I didn't accomplish anything, or how I have a lot of trouble remembering how I spent my time or how long it took me to do something, he told me he feels that way all the time, too. I talked to him about my lifelong struggle with procrastination, and I knew immediately that he understood what it was like. And while I only occasionally have trouble falling asleep, I've gone through pretty intense insomnia before, and I know how debilitating it can be.

I'd like to think that steak dinner was a turning point for Jeff as he grapples with this new reality. Only time will tell, I guess. If someone had sat me down at fourteen and started to rattle off a list of things that almost perfectly described things that were causing me a lot of inner turmoil, and then told me that it wasn't my fault, and that there were things I could do to make dealing with school and life a little more manageable, I'd probably be a very different person today. I think I'd at least be a little less insecure and experience less anxiety.

During our conversation, I suggested to Jeff that he try a white noise generator or some other kind of sleep sound device or app. In addition to masking the annoying random sounds that can really tug at an overactive brain, I've found that those kooky new-age nature soundtracks can often help relax my mind (I'm partial to waves crashing on the beach). The next day, Jeff texted me to say that he had tried a white noise app and that it had really helped him to fall asleep. It was pretty gratifying. As I told Jeff, we ADDers are a speciai tribe (about fifteen per cent of the population) and we gotta stick together of we're going to make it in this crazy world.

Flying with Focus

One of the more interesting and destabilizing parts of the past six months is that I'm learning a lot about myself since I was diagnosed with ADD. I have read a lot of the books out there on adult ADD, and it's extremely disconcerting to pick up a book and have a complete stranger identify in print so many of the fears, uncertainties, and traits I've struggled with all of my life.

I've learned enough about myself by now that I better understand why I find air travel to be so challenging. I'm in the middle of a four-city, two-week road trip for work, so now is as good a time as any to write about what it's like for me to travel with ADD.

Booking Air Travel

Trying to book an itinerary feels like walking into an open bazaar, with vendors everywhere shouting different prices at me for goods that are all slightly different. If it weren’t for travel search sites like Travelocity, Orbitz, Kayak and Hipmunk, I'd be a complete wreck trying to figure out timing for connections, finding the best prices, comparing itineraries and focusing on one airline rewards program. As it is, even with all the powerful search sites at my disposal, I find it incredibly time consuming and exhausting to book anything but the simplest itinerary. It took me more than half a day to book my current trip - between the complexities of a 4-city flight itinerary, hotels, car rentals and airport shuttles, all of which had to be within the per-city travel budget. It's a good thing I'm such a geek and have gotten pretty good at using the filters built into those search sites, otherwise I'd never get anywhere.

Packing

I hate packing. I’ve developed a ridiculous ritual every time I travel: the night before any trip, I usually end up pulling an all-nighter to do laundry and pack my bags. I used to attribute it solely to trying to do too much with too little time (which is true, but more on that in a future post), leaving no time to pack during regular waking hours like a responsible grown-up. I now recognize that there’s another factor: packing for a trip is exactly the kind of activity that taxes my ability to stay focused simultaneously on a number of small sub-tasks.

The process usually starts out well enough. I grab the appropriate luggage, and start gathering my clothes and other stuff. Then, I'll be unable to find a shirt I want to bring, and when I find it in the hamper, I think, "I'll just put in a load of laundry while I pack." That's usually the beginning of the end for my good start. What follows is... well, remember those Benny Hill cutaway scenes that were played back at high speed with crazy saxophone music, showing Benny and a whole gang of characters running around, bumping into one another helter-skelter? It's kind of like a one-man version of that, without any of Benny's scantily clad co-stars. I usually end up with things I didn't really need, like the book I've been meaning to read for four years, and missing things that I do need, like the charger for my phone.

The real problem is, because I'm at home with all of my stuff, I have a lot of trouble filtering out the universe of things I might need (umbrella, poncho, first aid kit, emergency zombie apocalypse supply bag) from all the things I actually do need (socks, toothbrush, glasses).

You might ask why, knowing full-well now that I'm not good at holding so many unrelated small tasks in my active working memory, I don't just create a list of things to pack. I've tried. Maybe I need to work on my list-making, but I start packing using the list, and inevitably I start thinking of things that aren't on my list and my trust in my past-self disappears because I see how unreliable I was in creating the list.

Anyway, I've gotten a little better at this. At least now I'm better at forgiving myself for forgetting things, and reminding myself that buying a tube of toothpaste or a bottle of contact lens solution at my destination is not the end of the world.

Flight

I'm blessed with the ability to sleep on planes. I sleep through takeoff, through landings, and often through most of the flight. If I couldn't do this, I'd probably go crazy. Flights are full of the kinds of distractions that rip my attention away from anything I try to do that requires focus, such as reading or writing. Put me anywhere within seven rows of a loud talker, and I want to rip my hair out in frustration (if I had hair to rip out), because I can't tune out the conversation, and I'm trapped for several hours. The constant drone of jet engines also, for some reason, pulls at me in a way that random noise in an office or in a car does not. And when the flight crew uses the overly-loud PA to sell their special credit card program, it takes a great deal of willpower not to scream in rage, especially if I've just barely managed to get into a groove and actually read my book.

I started using ear plugs recently, and it has completely changed my relationship to flying. I haven't found any that can block out as much sound as I would like, but the ear plugs I use now dampen noise so much that it really helps quiet my mind. I also use headphones - and I'm thinking very seriously about investing in a pair of good noise-canceling headphones - but I also worry about trying to block out noise with other noise and what that might do to my hearing. When I don't have ear plugs with me, I use in-ear earbuds with an app on my phone that generates white noise.

I'm happy to say that using ear-plugs and headphones, combined with better mindfulness about, well, my mind, have drastically improved my ability to concentrate while flying. I used to shift from reading a few sentences of a book, to flipping through a magazine, to glaring at the obnoxiously loud person three rows away to perusing the Sky Mall catalog, to playing a game on my phone, all within about three minutes, on a repeating cycle for the entire flight. I used to also try to actually do something productive on flights, but inevitably, I would take out my laptop and just stare at it in quiet frustration, unable to muster enough concentration to do more than write a few sentences.

Things haven't completely changed. I'm still very likely to wish a bad case of laryngitis upon fellow travelers who, like Austin Powers coming out of his cryogenic state, can't CONTROL THE VOLUME OF THEIR VOICE. But I'm a much happier and productive traveller now. I know this, because this post was written entirely in-flight, within earshot of two people who must be related to Sam Kinison.