"You’re Not ADD (Part 2): You’re Befuddled"

My daily routines were knocked off kilter by a head injury that lingered — revealing how much I relied on structure to cope with attention deficit.
Life in the Fast Brain | posted by Kristen Caven

When the Mini Cooper left an imprint of its license plate in the bumper of my Prius, the insurance company said it was still a low-speed accident, and I couldn’t really be that hurt. Even my doctor dismissed the possibility of a concussion, despite that bang my headrest gave me on the back of my head, messing up my upper neck pretty good.

Suddenly, my life was capital-D Disordered, and I could see how inherently un-regulated I was without my usual structures.

Three weeks later, Enzo was diagnosed with ADD, and my immersion into this new world began. I began recognizing the tell-tale patterns of ADHD in my own psyche that had been there all along. At the time, however, they were confuddled with the symptoms of Post-Concussion Syndrome (PCS) that I was experiencing.

PCS is a lingering condition that arises when a concussion doesn’t heal. At the time of the accident, I had been in the final throes of polishing the manuscript of The Bullying Antidote and going a mile-a-minute preparing for the next project, trying to figure out the bad report cards, and grieving from the sudden death of a dear auntie. Rest, schmest. The stress of life didn’t stop — bills to pay, food to make — but I could no longer stay in control of my time. I would have a few good days a week and then the wheels would fall off. I struggled to keep teaching my Zumba classes; exercise keeps me focused and productive like nothing else.

Symptoms of PCS include attention deficit, impulsivity, irritability, a low frustration threshold, mood swings, memory problems, impaired planning, communication difficulties, socially inappropriate behaviors, self-centeredness, and a lack of insight, concrete thinking, and poor self-awareness. (Sound familiar?) Another thing that happens with a concussion is your blood pressure can go haywire, since an injured brain can’t regulate things as well. When I realized exercise was bringing on symptoms, I had to give up my daily sweat.

With the dull ache in my head, all of my other stabilizing structures became more difficult, too:Meditation would just put me to sleep; I couldn’t remember to take my herbs and vitamins; and I didn’t have the energy for my organizing routines. With caffeine off-limits, I couldn’t reach for a cup of focus.

Episodes of inattention began to mess up my life in big ways — like the time I didn’t go through all the steps properly when moving into my new computer, and lost my data when the robbers (yes, there was a break-in, too) dropped it on the way out.

Suddenly, my life was capital-D Disordered, and I could see how inherently un-regulated I was without my usual structures. I realized I had been living (somewhat successfully) with undiagnosed ADD all my life...but I couldn’t get the help I needed until my head had fully healed. Every medical professional I approached diagnosed me with capital-A Anxiety, which I most certainly was suffering, due to the not-raining-but-pouring challenges in my life.

Now that it’s all behind me (PCS sufferers, have hope!) I see what a valuable experience I had. I have so much more understanding and compassion for head injury now. The hardest part about a brain injury is that you can’t put your head in a cast, so people can’t see that you’re injured. Like mental illness, it’s “all in your head.” You can’t function like a normal human being, and you feel invisible and misunderstood.

I ended up doing eight months of counseling about feeling invisible and misunderstood. It was good to have somewhere to go and cry once a week, but my therapist could not really see or understand the ADHD connection beyond the trauma in my addled brain.

The Forklift of Love

Getting a sleepy ADHD teenager out of bed calls for heavy machinery — and a lot of patience from the crew at home.

Until we learned about ADD, it was always a mystery why our little guy couldn’t sleep. Even though Enzo, as a small child, was more than once called “The Thing That Would Not Sleep” by his exhausted-to-the-point-of-a-horror-movie parents, he was a blessedly solid sleeper once he was down. Yet, he surprised us all (as teenagers do) by growing up to be “The Thing that Would Not Move.”

Sleeping past nine! Oh, how we reveled in those luxurious summer mornings! It was like being newlyweds again!

Baby Enzo was better than an alarm clock. Even before he was born, I could never stay in bed past 6 AM. During his first decade, those bright little eyes would fly open at six…fricking.…AM. Even on weekends.

Later, when school days became a grind, he’d sleep in until seven. But on weekends, when there was so much more to look forward to, the son would still rise with the sun. "I've got a lot to do today," he'd say when we stumbled into the Lego jungle.

We were so proud the summer before eighth grade, when he took up a new hobby: sleeping past nine! Oh, how we reveled in those luxurious summer mornings! It was like being newlyweds again!

Now that he’s pushing seventeen, the novelty of that has also worn off. On weekends we don’t see him until noon. And on school mornings, trying to get both that brain and body working takes nothing short of heroics.

Trying to wake up a teenager on a school day is not easy for anyone. Trying to wake one with ADD is like trying to get a pig to fly, according to his father, "Dave." ("It's a waste of time, and it annoys the pig.")

His first alarm goes off at 6:15. It’s a song, or rather some electronic song clip, that he has chosen the night before, and it is set on repeat on the iPod that rests in the speaker on his headboard. At 6:30, his clock alarm starts beeping, and now there is a funky rhythmic jam going on in his room. At this point, his dad starts grumbling: “I could always get myself out of bed. This is nonsense.” (Dad has learned to go to work early to save his sanity.) A few minutes later, the radio goes off.

By 6:45, if Enzo has not crawled out to turn off the beeping yet, I go into his room and start shaking his loft bed. Sometimes it takes an earthquake. When he was little and we needed him to move, we’d just bring on “the forklift of love” and lift him out. That became an impossibility after he reached the hundred-pound mark.

Half the time — and I swore I would never do this — I get angry. I start shrieking things like, “Oh, my God! It’s 7:30 already!” Or I get snotty. "Okay, I'm driving you to school without you." But I hate to go this route. While others might respond to the stress in my normally calm voice with a shot of adrenaline, Enzo doesn’t seem to have been built with this response. For him, motivation must come from within. Nagging backfires. In the mornings, the higher-pitched my voice goes, the more he shuts down.

But what goes on in that brain? When I was younger, I remember having just as much trouble getting out of bed, especially after a night of brain-racing. There are stages you have to work through in that transition between the sleep state and the awake state, which, according to the experts from the sleep study Enzo participated in, are constantly at war for our time. “I am working things out,” he mumbles. He’s still achieving the mystical tasks his dream set out for him.

On a good day, he’s up to kiss his dad goodbye. He gets dressed quickly...and then lies down for a pre-breakfast nap.

The Tension of Attention

Physician Gabor Maté’s explanation of eye contact, attachment, and the origins of ADHD.

One of the best ADD books I read while researching my book on bullying was Scattered: How Attention Deficit Disorder Originates and What You Can Do About It , by Gabor Maté. If you haven’t seen Maté's YouTube videos, check them out. He has an interesting view of ADD, and here it is, in a nutshell of my own design:

The Interest-Based Nervous System

"Almost every one of my patients and their families want to drop the term Attention Deficit Hyperactivity Disorder," writes William Dodson, M.D., "because it describes the opposite of what they experience every moment of their lives. It is hard to call something a disorder when it imparts many positives. ADHD is not a damaged or defective nervous system. It is a nervous system that works well using its own set of rules."