You’re Not ADD (Part 5): Want some Prozac?

Trying to get a diagnosis can be quite a thrill ride.

On my health plan, they have a process by which people are diagnosed with ADHD. First, you go to the 2-hour talk on Adult Attention Issues, where they pass out a test. Then you wait three weeks and they send you a letter. Yes, you have it. No, you don’t. It’s like getting accepted into college... or not. If you do, you get some meds and 4 appointments with a therapist who may or may not know anything about ADHD in adult women.

“When you have ADHD,” the teacher droned on, “you need to be entertained or you lose interest.” I wanted to bolt after twenty minutes of her slow-moving, monotone presentation.

— Kristen Caven

If, because they have awesome services in the Pediatrics department, you ask your child’s psychiatrist something like, “I think he’s this way because of me,” they won’t really talk to you; they’ll say to go stand in line in the Adult department. (If you cry, because you don't understand and are desperate to ask questions like "is it because I was a terrible mother and could never teach him how to floss every night because I can't remember to myself?" Well, they’ll close the door extra-fast.) So, you just keep worrying and having all these questions that no one will answer until you do all your listening first.

In the Adult Attention Issues session, which is standing room only, they describe every aspect of what it feels like to have ADHD. I sat through this meeting twice, five years apart, and had to sit on my hands to keep from raising them every two seconds to chime in with additional information, since it was all so familiar. The test is full of questions that make you sound like a loser, which I’m not. On some questions, I had to be perfectly honest and answer both “Rarely true” and “Always true,” since one answer is correct when I’ve got fun things going on in my life, and the other is correct when I’m feeling overwhelmed. I wanted to explain this to someone, but no one ever asked me what I meant.

The first time I went through the process, they said I was on the borderline, not “disordered” enough to have ADHD, and the psychiatrist kindly offered me some Prozac or other anxiety medication. But I am not a fearful person, I told her, just an overwhelmed one. I only really worry about one thing: can I keep my shit together without dropping all these balls I seem to attract? Besides, I am keenly aware of my body and highly sensitive to medications; I even ask the dentist for a half-dose of novacaine. So Prozac? Thanks but no thanks.

The second time I went through the routine, same story...except now you had to wait 3 months to talk to a psychiatrist if you were 'borderline'. I decided to go ahead and take the 6-week Adult Attention class while I waited. It was all I could do, again, to keep from blurting out and being the cleverest one in the room. “When you have ADHD,” the teacher droned on, “you need to be entertained or you lose interest.” I wanted to bolt after twenty minutes of her slow-moving, monotone presentation. The woman next to me was just as agitated at the poor organization. We supported each other in chiming in. But the teacher said, “please hold your questions and comments until the end.”

One day I got a call, asking me not to return to class. I was baffled and hurt, feeling like I did in first grade when the teacher saw me as a trouble-maker after I screamed from a bee sting. The concussion had added to my antsiness, but was I really as disruptive as they said? Turns out they had intended to kick my confidante out of class for other awkward reasons, and the teacher (who assured us she didn’t have ADD), mixed us up. But I couldn’t take any more. They gave me a refund and I went back to square one.

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"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.

In the Mood for a Funk?

Living with rejection-sensitive dysphoria — the soul-sucking downside of attention deficit.

I wrote recently about the first thing William Dodson, M.D., says everyone with ADHD has: anInterest-Driven Nervous System. The second thing he says everyone with ADHD shares is an emotional response called Rejection-Sensitive Dysphoria. I kind of don't want to write about it, because there's that impulse to skip past the hard stuff and focus on the fun stuff. But it's hard when your mood falls off a cliff for what seems like such a little thing.

You get so tired of this feeling you want to give up before you even start.

— Kristen Caven

If you have this thing, you know what I'm talking about. If you don't, imagine (or remember) yourself as a teenage girl whose stomach is churning because there are so many choices in her closet and it's impossible to choose an outfit and the wrong combination could give her away as being different and bring the harsh and ultimately life-ruining judgment of her peers.

Or, a boy who lashes out at his brother's friends because it seems like he's never getting a long enough turn in the video game and it's not fair. Or a child who squeezes into a corner behind the door and cries at their own birthday party because things are not going the way they imagined. Or a grown-up who throws a party and can't seem to be in the moment to enjoy it.

It's what, eventually, makes you lose interest in that job you thought you wanted. Or hit "close window" instead of "submit" because you are not confident you'll win that award. Or fall into a funk and turn into a jerk when that guy/girl you like likes someone else. Or talk yourself out of liking that guy/girl as you eat/drink your troubles into oblivion. It's yeah, didn't really want that; those grapes were sour anyway. It's what keeps you stuck. Or going around in circles. You get so tired of this feeling you want to give up before you even start. It's one reason why people with ADHD don't achieve their potential. It's why an older man will decline an invitation to socialize because he's realized, or decided, he's "not good with people."

It helps to know RSD is a thing, if for no other reason than to be able to go, "Oh, now my brain is doing that thing it does." It helps to know that social skills might not come as naturally to you as they do to other people. And it's okay to get some help breaking down the details so you can understand the rules.

Acceptance of the downside of ADHD also helps you accept the upside. And, fortunately, in keeping with my theory that the nature of ADHD carries the seeds of its own cure, there are at least two wonderful upsides:

1) Forgetfulness can be a blessing when it comes to bad moods.

2) Some sparkly distraction will surely come along soon!