Alaska, ADHD, and the Hunter-Farmer Hypothesis

Lately I've been neglecting the blogs I used to read, so I wandered over to Gina Pera's ADHD Roller Coaster to see what I've been missing.  I found an interesting guest post about the prevalence of ADD traits in Alaska.  After the author was first diagnosed, she started to notice that an unusually high number of her friends and relatives also had ADHD traits.  So she checked with them, and lo and behold, many of them had been diagnosed with ADD.

She makes the point that Alaska is tailor-made for people with ADHD.  There's plenty of dangerous, adventurous work to do for those of us who loathe the thought of traditional desk jobs (and I should say here and now that I used to harbor a fantasy of moving to Alaska to become a bush pilot).  To me, though, the most interesting part is when she describes walking through the woods with her sons.

When her sons are outside, suddenly their "distractibility" turns into "noticing things":

They are attuned to every detail of their surroundings, noticing each chirping bird fluttering softly in the brush and each animal track on the ground. Given the high probability of us running across a bear during our excursions, I find their hyper-awareness to be quite a relief. In a school setting it gets them in trouble; in a wilderness setting it could save their lives.

Now, I'm generally not one of those people who feels that ADD is some sort of gift, that people with ADD are somehow "more creative" than others.  I've known too many creative people who don't have ADHD, and they're a lot better off than I am -- they can follow through on their creative projects, and actually get around to putting them out into the world.

There is, however, one area where I do feel ADD confers a gift: when I'm outside, I notice a lot of things my non-ADHD compaions don't.  Quite simply, I'm "distracted" by every bird flying overhead, every rustling in the grass, every mark I see the ground.  I notice foxes and rabbits and quail and coyotes.  I see hawks diving for their dinners.  I spot whale spouts offshore.  Sometimes, my companions luck out and I can show them what I see.  Often, though, they miss out -- the wildlife has vanished by the time I point it out to them.  When I'm outside, I'm not "disordered", I'm "observant".  In this one area, ADD means I have an advantage that others don't.

Abilify 2 mgs: Holy Clumsiness, Batman

I've written about the Lamictal Stupids before, and how Abilify seems to make them that much worse.  Did I also mention that Abilify makes me really damn clumsy? 

Yesterday I broke the last of our entry-level Reidel bordeaux glasses.  We used to have two.  Now we have none.

Care to guess when I broke the other one?  It was last year.  Shortly after starting my winter course of Abilify.

The glasses were a gift.  They were our favorite wine glasses.  They suited our shared taste for red wines, and they're suited well to a lot of California reds.  Before you go thinking that we're affluent wine snobs, we're not -- our "house red" is a five dollar bottle of cabernet or shiraz or whatever else Trader Joe's has for five dollars.  We loved those glasses so much because they made cheap wines taste like NOT cheap wine.


Of course, you may have guessed that if you read last week's post about how I gave myself a third degree burn on my forearm while taking pizza out of the oven.  I've burned myself with the oven before; occasionally I graze my hand or arm on the oven rack, resulting in a small, minor burn. Never before have I actually made contact with the metal that lines the oven.  Never before have I gotten a burn that's an inch long.  Let alone one that's scabbed over, and that doesn't even hurt -- that last bit indicates nerve damage.  Yay!

Oh Yeah, My Mood Action Plan

My experience the other night made me remember that I'd created a Mood Action Plan back in the day.  I've printed it up and posted it above my desk/studio table.  I've already acted on some of them -- namely those that deal with my daily mood crashes:

• Troughs or crashes in mood between the times of 4 and 8 pm become more frequent
• Troughs or crashes in mood between the times of 4 and 8 pm become worse (tearfulness, paranoia about relationships, pessimism running to despair)
• Troughs or crashes in mood lengthen beyond the 4 to 8 pm range

All three of these symptoms are occurring, a fact to which I have alerted my pdoc (which was action number 1 on my Plan). We're trying an Adderall booster in the early afternoon, but it's proving to be problematic for my sleep if I don't get in some vigorous exercise during the day.  And I do mean "vigorous". It has to be weight training -- going for a run don't cut it.

Depression, ADHD, and Radical Acceptance: When You Can't Make The Changes You Need (Right Now)

There's an excellent post over at 18 Channels about "radical acceptance".  Radical acceptance is probably called many things by many people, but the general idea is that when you're facing a situation you really can't change, you need to just accept it and live with it until you can change it.  I guess it's a mindfulness practice, really.

It's a valuable thing for me to keep in mind right now.  I've lost a lot over the past year.  I lost my job.  I had a bad injury to my neck and shoulder.  I lost my mind to psychotic depression.  I lost several months of my life to the wrong med.  And I lost the relationship I thought I had, the one that I thought was working, the one thing that I used to look at and say, at least I've gotten one thing right in my life.

My New Mood Action Plan

Yesterday I wrote about my Mood Action Plan.  There was some room for improvement, though I got a few things right.  Hotbrain, who's been at this longer than I have, agreed that telling your partner and your pdoc, if you have one, are both good things.  If you live with roommates it probably helps to let them in on your action plan as well, and let them know if you're feeling a little wonky.  This, of course, depends on how much you trust your roommates.

At our last MCBT class last night, we paired up with other class members to discuss our plans.  My partner also happened to be a visual artist.  He said that he'd had the chance to put his plan into action the day before (yay! depression!) but he'd run into some problems.  For instance, one of the items on his plan was to draw, because it makes him feel better.  That is, it makes him feel better when he feels like the sketches are going well -- and of course, when you're already depressed, you won't feel like your sketches are going well.

This made me think to add art to my own action plan.  It also reminded me of a story I'd we'd read and discussed in my MFA program about a ceramics class.  Half the class was told that their grade would be determined by a single bowl, so they needed to make the best bowl they possibly could.  The other half of the class was told their grade would depend on how many bowls they made -- the quality of the bowls didn't matter.

Guess which group made better bowls?

Yup.  The pressure was off the second group.  Their bowls were more beautiful and showed more creativity.  Why?  Because they could take risks.  The quality of their work didn't matter, and the result was the quality of their work was better.

I digress into this story because it's all too easy for someone in a depressive state to judge themselves harshly, like my group partner was judging his sketches.  A way around this, I thought, was to assign one's self to make 10 sketches, spending two minutes on each one.  If they don't turn out, who cares?  You only spent two minutes on each of them.  But I've worked this way before, and I know that chances are better that at least two or three of them will be worth pursuing further.

If only I could come up with an analogous practice with music ...  Anyway, here is my revised action plan, with revisions in red:

My Action Plan for Mood Symptoms Consists of the Following Steps:

• Breathing Space (use breathing space to check in: would meditation be helpful or harmful at this time?  What is the best self-care I can give myself right now? What steps do I need to take next?)
• Make a choice of what practices are most helpful to me and start using them (be nice to know what these are … sitting meditation or yoga? Try walking meditation?)
• Take specific actions, including the following steps:

1. Inform spouse
2. Inform pdoc *** if spouse is traveling, this is Step 1 ***
3. Determine what would be the best action toward self-care and do it immediately Choose among the following things:
1. Play some Bach (if order needs to be imposed on the universe) or Chopin (if feeling emo)
2. Make art (work on current project if it can't be "screwed up"; if current project is in a delicate state, make 10 sketches, taking two minutes for each one)
3. Spend time with friends/make plans with friends
4. Do housework (yeah, I know; I've somehow become one of those people who finds this soothing. Please don't hate me)

The one thing I think I need to add to this is to enlist friends who I can check in with. My partner travels a fair bit, and might not me around to notice a change in my mood, or to do anything about it if I tell him. My psychotic episode, for instance, happened when he was in Germany on business. Poor guy came home to a house full of aluminum foil.

Day 47, 100 mgs: Treating Mental Illness Like An Illness

I've mentioned before that I'm taking a class in mindfulness-based cognitive therapy (MCBT) for depression.  We're taught various meditation techniques, which teaches us mindfulness skills, which allows us to be aware of our thoughts, which in turn allows us to recognize thoughts that are depressive, and finally, allows us to release those thoughts.

Last week we talked about caring for ourselves if we relapse.  The hope is that the meditative practice will help to prevent this, but also that it will allow us to notice a relapse before it gets too bad.   It's important to be mindful of the physical and mental symptoms that herald a depressive episode.  Depression, the facilitators explained, tends to follow a pattern in a given individual.  Our homework for the week is to write down what these symptoms are and write up a plan in the event that depression strikes.

This was slightly depressing to me, because in my case, the "usual symptoms" have changed.  Wah!

But a more interesting thought occurred to me: in all my years and years of therapy, none of my mental health care providers ever thought of doing this.  WTF?

Mindfulness CBT: ADHD, Anxiety, Mood, and a Helpful Hack

I've mentioned before that in addition to my crazy, I have ADHD (predominantly inattentive type).  Like a lot of ADD-ers, I've been scared to death of trying meditation.  I've done other spiritual practices, like guided visualizations, or trance work, but meditation "just didn't work for me".

A lot of this has to do with past trauma related to growing up with ADHD.  When you've been shamed your whole life for your failures in attention, anything that sounds like paying attention will raise your defenses.  I'm bad at paying attention.  Everybody always said so, and then I got a diagnosis to prove it.

Since I started taking a class in Mindfulness CBT, I've come to realize something very important -- the only thing required for meditation is that you know how to breathe.

I wish I'd learned this years ago, because I can already tell that meditation is helping me a lot.  It helps even though I don't do it every day like I'm "supposed" to.  I've discovered that I'm calmer after meditation, whether or not I was aware of feeling anxious before.  It lifts my mood if I'm in one of my late-afternoon slumps.  I can't say that it's made me more mindful overall (the goal of the class is to teach us to be mindful in general, so we can recognize our depressive thoughts before they really seize hold of us) but it's definitely helpful in the moment.  And "in the moment" is where you're supposed to be when you meditate anyway.

So how can you possibly meditate when you have ADHD?

Lamictal Day 34: Mood Instability and Depression Due to Variance in Lamotrigine Generics?

Last Friday, day 28, was my first bad day since I started lamictal.  Saturday was my first day at 75 mgs, but I filled my scrip at a different pharmacy, and that meant a different generic manufacturer.  I'd been taking lamotrigine made by Teva for the first four weeks, and now I'm taking NorthStar.  Since then, I feel like I've had many more bad days than good. 

This really feels like a different, less effective medication.  My mood, cognition, and motivation are all suffering.  There have been some days where I've bee unable to get important things done, like cooking dinner or getting scrips filled.  Looking back over the last several days, I'm clearly much less stable than I had been (and I'm not remembering this accurately, which makes me glad I'm keeping this damn blog).  I'm back to my 4 pm crash.

Today, I feel better than I have most days since starting at 75 mgs, but I still feel way lower than I did last week, or any day of the previous 4 weeks.  This sucks incredibly.  I'm trying to just sit with it, let it be what it is, and not get caught up in depressive thoughts. 

Still More About Psychotic Depression: Why I Didn't See It Coming

My psychotic depressive episode happened after several fairly stressful months.  When it happened, and in the months since, I've been blaming myself -- I knew I was getting stressed!  Why didn't I take better care of myself!

The stress involved money and employment.  Early in the year, my husband had taken a job at a startup that entailed a significant pay cut.  To make a long story short, I had believed that I would be able to make up at least some of the lost income, and it turned out that I couldn't.  My husband's job is far from where we live, and he was trying to make a go on public transit, but the time this took was truly ridiculous.  He was getting stressed and snappish.

I was also getting stressed.  I could see my thoughts heading into depressive territory: I'm just unemployable.  I'll never find work.  How did I think I could find work, with my spotty work record and 10% local unemployment?  Who in their right minds would hire me? Et cetera.

MCBT Homework and ADHD

I'm taking this class in mindfulness-based cognitive behavioral therapy.  I feel like it's helpful -- I certainly feel calmer after meditating -- but on the other hand, the class started just after I began lamictal.  I can't tell what's the drug and what's the meditation.

The class requires homework, and I'm having trouble remembering to do it.  Maybe blogging about it will help.