My 16 year old daughter was diagnosed as Attention Deficit Disorder and then, at the age of 57, so was I. A lifetime of struggle was placed into a context that made sense of a lot of failure and frustration. This blog documents and celebrates what has happened to me since.

Saturday, December 23, 2006

transcription errors

I just finished a very interesting book called Misquoting Jesus, by Bart Ehrman. I recommend it to anyone who reads the Bible but that's not why I bring it up.

For as long as I can remember I have marked up books as I read them. I most frequently use with some kind of highlighter, although I have also underlined in pencil. I began thnking a long time ago that I should at least go back, at the end of a reading session to look at what I marked but I didn't until quite recently. A month or so ago, as I was reading a college text book (again about the Bible, as it relates to the history of the early Christian movement) I started each morning's reading session by reviewing that which I had marked the previous day.

I have also thought that I should take some of what I marked and transcribe it somewhere, in some form, that I could find things, again, when I had need of the source of some reference. But I never did that, either, until I started with this book. Doing this, creating a digital file called "Notes: Misquoting Jesus," was not just, it turned out, a useful process of abstracting for later reference, it was also both a discipline (in regard to "overcoming" my ADD) and it was an object lesson in what this particular book was about.

As I transcribed passages from the book (some of them quite lengthy) I made mistakes--in just the way the author describes one of the ways that the scribes who copied the Biblical documents made mistakes. Not paying attention, letting my mind wander--whatever it can be called, there it was happening, right before my very eyes. I was doing it.

The discipline of this transcribing is really good for me. The kind of concentration that I want--which I imagine (quite wrongly, I am certain) that everyone in the world has who is not ADD--requires me to consciously concentrate. And that is something I have to practice. Perhaps some day I will have that kind of concentration without constant self reminding and perhaps I will not. I would hope that this habit, and the medication, would result in that. But even if the habit and the medication only result in my consciously concentrating more often I am still the winner.

I have been doing the Concerta for about eleven months, now. What I have learned about it, thus far, is that it is not a cure, in and of itself. I struggled for fifty odd years trying to come up with a set of habits, a modus operandi, to do better work. At times I did think I was ADD but I never followed up clinically, partly because I didn't really think I was ADD (after all, don't people "outgrow" ADD?) and partly because I would be seen as a "drug seeker." But I did read the self help books and the books on organizing one's life (want to borrow some? I still have a modest shelf of them), in so far as my disability allowed for it, I was introspective about myself and the way I went about things. I built up quite a repertoire of strategies that I employed inconsistently. The results were inconsistent. But the medication has enabled me to be more consistent in employing the strategies.

Damn. I wanted this to instant and painless and forever. It's work. But it's really, really working.

Friday, November 24, 2006

Subtract, don't ADD

The word "focus" has been surfacing in my thoughts, recently. I have so many things going on and I am having trouble making progress with them. Classic Attention Deficit Disorder.

The cycle is as old as I can remember: take on tasks, make lists, figure out when things will get done, add more tasks, make room for them on the list, procrastinate when something comes along that looks more interesting than what is on the list (procrastinate meaning "figure out a time in the future when you could do what you should do now and then decide to do it then"), add more stuff, take more time away through an impulse or accommodating an unexpected task or just to escape the pressure of getting all this stuff done and--voila!!! I am completely overwhelmed and it comes tumbling, in way or another, down.

Impulse underminng Focus.

Impulse. Focus.

Aside from the mundane, quotidian things in front of me (keeping the house going and in order, doing laundry, getting the children where they should/want to be, getting the cars serviced, the yard taken care of, the dogs and cats to the vet--and there's a lot on tht list that needs a lot of attention at this moment, at any moment), I have several other projects on my list that are calling my name, right now. In so far as I actually deal with them it is most often in a haphazard way, determined by which is the closest to sending me over the edge; where is the most pressure coming from at the moment.

When I was young there was a juggler I used to see on the Ed Sullivan Show. He would spin plates on sticks on a long table on the stage. The plates were balanced on the top of these sticks and they would go until their momentum was exhausted and then they would fall. Well, they would have fallen if he had let them, but he didn't. He got many plates spinning at the same time and would go from plate to plate, spinning the sticks between the palms of his hands to keep the plates going. As one plate needed more of his energy he would go to that plate and give it attention. There was one on the end of the table that he would neglect (on purpose of course) until the audience was screaming at him to spin it. He would get there on the last possible wobble, of course, just before, for lack of his attention/energy, it would crash to the floor.

I have often compared my life to that collection of spinning plates. Sometimes one or more--sometimes almost all--of my plates have come crashing down for lack of ability/energy (and skill) to keep all spinning.

I have never been good at limiting the scope of my activities. And I have never been particularly good at most of them. I have always tried to do too many things to be outstanding at any one of them. I have, most usually, tried to do so many things that I was never even very competent at any of them.

And I have serial enthusiasms. I am interested in something for a while--to the exclusion of other things in which I am interested or should be doing--and then I lose interest and move on to something else. Often I go back to one of these interests but I will move on, again.

There are so many interesting and attractive things to do, in this life. There are so many things that have distracted me, in this life.

My energy gets scattered in this way. A big chunk of it is invested in novels that will never be finished. Another chunk can be found in a baseball card collection that is in dissarray and will never be otherwise. The latter activity goes back to my childhood, the former to my adolescence. There are a lot of other artifacts of my energy around.

It is not all gloom. I can see things into which my energy has gone and much has been accomplished. My relationships with my children and with Lynn and with (some) other people, my legal knowledge and expertise, my teaching skills, my spiritual development. Yet, even in these things the pattern holds true, to some extent.

Focus. Impulse.

There are some things I want to get done, both in the short and the long run. (And at 58 there isn't such a long run, left). I am realizing that it's going to be about taking things out of my life, now, and not adding any more. Or, if any more is added then some things have to be taken out.

The spiritual tradition of the Society of Friends is of that type. The simplicity that grows from that kind of direct and transformative relationship with God/Spirit is the result of recognizing things that conflict with it and removing them from one's life. It is the work of the Adversary/Devil to keep one's life so complicated that we are out of right relationship with ourselves, those around us, what's going on around us, and with God. Confused and exhausted and frustrated by complication we are lost and we are unable, and convinced that we will never be able, to do (let alone see and understand) the work that God has for us to do.

Medication, the process of being matured and transformed by God/Spirit, worldly experience, reasoning and sorting things out over time--put it all in a jar and shake it until smooth. The product is a realization that I have to focus, in big ways and small. Whether it is laying down some project altogether in favor of another or just not picking up a magazine on the way to the bathrooom to prevent myself from getting getting interested in an article and taking an hour away from the project upon which I was working, the point is to focus, to eschew the influence impulse, and don't take on as many tasks/interests/activities as I can remove from my life.

Just say no, is, the phrase that comes to mind. Say no to others, say no to myself, say no to the demands of the momentum/intertia of my life and the things I am carrying through it. Simple, but not easy. ADD wants to add things--things that crowd out other things until those things, in their turn, are crowded out and until all of the energy put into all of them creates little, if anything, that endures beyond the moment of its release.

Simplicity gets a good Quaker boy to Harmony.

Subtract, don't ADD.

Monday, November 13, 2006

Bowling, too.

My younger brother was in town for the weekend and we went bowling.

He and I have a history with bowling. Our parents taught us to bowl early and kept us in junior leagues until we graduated from high school. They didn't need to force us to do it. We liked it. Neither of us were great bowlers, for different reasons, but we both had a good time, most of the time, although we were both frustrated by our inability to do as well as some others. We were low middle of the pack in our abilities.

He kept at it, over the years, and has developed into a decent bowler. He is actually in the Southern Oregon Bowling Hall of Fame but mostly because of his work with junior bowlers and with Special Olympics. He works at a bowling "center" (we are not allowed to call them "alleys" any more).

I didn't keep at it. I bowled for a while in the Marine Corps and actually saw my average jump about thirty pins. I left off, in high school, in the low 150's and got up to the low 180's. But I didn't see any reason to keep it up. It still frustrated me. I had an unbreakable tendency to rush the line, to (I now understand) get to the line before the ball did, and then to throw the ball hard. That lack of timing and hard throwing ruined my form and made me inconsistent. Inconsistency in something like bowling is an assurance of erratic--and mostly poor--performance. Such performance is frustrating and a low tolerance for frustration is made even more damaging to a person when a lot of frustration is what their poor performance brings them. I think they call this a cycle of some kind...

I did take a bowling class in college when I needed a PE credit and it was ok to be at the top of the class. How many years did I have behind me, at that point? It was a bunch of beginners. I felt like Dick Weber.

I have had a ball in my hand a time or two since then, usually when my brother and I got together. Mostly it was after my girls were born and they wanted to try it. Each time I went I realized that I was not really good at this, that the middling skill I had developed once had eroded and left me erratic and frustrated. One time I would throw a beautiful strike and the next time I'd knock a couple of pins off of one side. Spares were really hard. I had no desire to do it again very soon.

But last night was different. Last night was the first time I bowled since my ADD diagnosis and since I started on medication. Like so many things I have done a lot in my life (and not done very well), I found bowling a much improved experience.

I was able to concentrate in a whole new way. I always knew what I was supposed to do to be able to bowl well. It was never lack of knowledge of the technique that held me back. It was always an inability to control myself, physically, mentally and emotionally that was the problem. I "could" not employ the technique I knew I was supposed to be using.

The setting last night was not conducive to good performance, for me. Lots of distraction. It was open bowling, with young children on lanes on both sides, who knew nothing of the taking of turns. They rushed up when they were ready and hung out at the foul line--often partially on our lane--as they watched the results of their rolling (or bouncing) of the ball. And my own family was not "centered" on bowling the way a team would be, so it was not always easy to keep my mind on what I was doing. Finally, of course, I was caught up in the good natured (?) competition with my brother.

But I realized, almost from the first ball, that things were going to be different, last night. And different they were. I didn't set the world on fire but for one who had not had a ball in his hands for a long time, I did very well. I was thinking, all the time, about what it was I was supposed to be doing and was able to actually do it a lot of the time. I realized that I could, with some time, to get back into the groove, be much better at this than I ever was before. I wanted to join a league, do this regularly. I felt, as I have so often felt since I started on medication, to revisit the "site" of previous humiliations and conquer. Yeah, you know, like going back to the seventh grade and taking science, again. Or going back to that first date...or the second or third one, for that matter.

Will I do it? Will I make bowling a part of my life? No. Not likely. Who has time? My life is already full and too full. But, standing there, holding that ball, looking at those pins, I had another reminder that I am disabled, and have been disabled all of my life. A lot of the frustration I have felt in my life at being unable to perform as well as I wanted to was not due to something about which nothing could be done, something beyond my control. I was not, as I believed (and still on an emotional, habitual level, believe) doomed to a life of being "no good" or "substandard." I can do something about it, now. I can.

I don't have to go back and show myself, in every situation in which I failed that I can succeed, although it would be satisfying in some ways to do that just to show some people that I am not as bad at things as they thought I was. It's plenty to be able to move forward with what is happening in my life, now, to apply what I have learned to what's on my desk, today.

But, man, I wish I could have another shot at playing baseball as a kid and as a young man.

ps. I saw a great cartoon in the New Yorker recently. Typical drawing; man is on the couch, psychiatrist sitting there with his pad. And the psychiatrist says "If you're happy and you know it stick with your dosage."

I read that and grinned, from ear to ear.

Golf! Oh, my! Where are my golf clubs?

Sunday, October 29, 2006

does medication for ADD/ADHD lead to adult substance abuse?

some studies re use of medication for ADD/ADHD and future substance abuse and addiction

http://pediatrics.aappublications.org/cgi/content/abstract/111/1/179

(Conclusion.Our results suggest that stimulant therapy in childhood is associated with a reduction in the risk for subsequent drug and alcohol use disorders.)




http://

(Conclusion. This study concurs with 11 previous studies in finding no compelling evidence that stimulant treatment of children with attention-deficit/hyperactivity disorder leads to an increased risk for substance experimentation, use, dependence, or abuse by adulthood.)



It does seem to be well established that ADD/ADHD, themselves, untreated, do have a high correlation to adult substance abuse. a study representative of this is found at

http://

Saturday, October 28, 2006

A legislative fix...

At a Joint House and Senate Judiciary Committee hearing earlier this week I heard a presentation on methamphetamine. Members of the Oregon Legislature are very interested in the problems posed by methamphetamine, as well they should be and what they were hearing from a panel of scientists was background information to aid them in making policy on law enforcement and substance abuse treatment.

At one point in the hearing one of the Senators asked whether giving "all those amphetamines" to children wasn't setting them up to become meth addicts. This was a question off of the topic that the scientists who were testifying were there to address but after saying that there was great disagreement about that in the scientific community it was also likely that pharmacological treatment of neurological disorders like ADD and ADHD prevented some who undergo it from becoming addicts later.

True.

I know from my work co ordinating policy for the drug and alcohol treatment courts in Oregon, as well as from person experience as one with ADD, that this latter "likelihood" is far more likely true than the former. (In fact, although I do not claim a comprehensive knowledge of the scientific literature I don't think I have ever heard anyone say that prescribing appropriate medication for ADD and ADHD made one more prone to meth addiction than children who were not. Perhaps someone has some data...)

But I know that people with conditions within this cluster of neurological disorders do self medicate and some of them use methamphetamine (as well as dexies, bennies, and cocaine. And alcohol. And caffeine). I once heard a judge ask a woman, a drug court client in court who was a recovering meth addict, how we would know if she had relapsed and was back on meth. The woman said, "I'd be sitting here calmly." The woman, I believe, suffers ADD and was self treating herself with meth.

My own life--including alcohol and substance abuse as a young person--is a testimony to this kind of self medicating strategy by people who have this disorder. One of the many benefits of my beginning to take Concerta is that it has cut my drinking of alcohol down to below what is considered an "acceptable" level. I drank alcohol more before beginning medication.

I talked to the Senator later in the hallway and explained that the "amphetamine" that ADD and ADHD children are presecribed is not meth, while it is a related substance. The scientists who were on the panel, also involved in this later conversation, validated my explanation that related drugs are do not have the same effect on people--that good, healthy results can come from a medication that is very closely related to an unhealthy drug (and that a medication that has a good effect on one person can have negative effects on another).

She explained that she was relating what they said to a negative experience she had as a young woman when a doctor, thinking she was overweight, prescribed "amphetamines" for her. She said it was a negative experience and that she couldn't take them very long.

I hope that the Senator heard what we were telling her. I hope she understands that her reaction to whatever she was prescribed was very different than that of children who are appropriately prescribed things like Concerta to regularize neurological functioning. I hope she understands that, while, in a way, her wondering about drug addiction and the use of pharmacological treatment of children with ADD and ADHD "made sense," she also understands the actual complexity of that about which she was wondering aloud.

There is a lot of bunk being promulgated about ADD and ADHD (I heard someone on a local radio station who wrote a book saying that ADD and ADHD are the result of bad parenting--that it comes from indulging children prior to the age of three). Some people are reluctant to believe these conditions exist because it cannot be "seen."

But it can be seen. The results of the clinical evaluations undergone by my daughter clearly show the manifestations of the disorder--as clearly as looking at a thermometer shows the manifestation of a fever, or the digital readout (used to be the reading of a dial) shows the manifestation of high blood pressure. And, of course, my life clearly shows that it exists.

I am realizing, as I openly talk about my own condition, and that of my daughter, how important it is for people who have experience with ADD and ADHD to speak out and to make it known what's going on and how it has to be dealt with.

Taking a "drug" is only part of the picture. A pharmacological regimen also has to be bolstered by developing behavioral strategies to overcome the limitations on functioning. Oddly, I developed the strategies before the medication, while my daughter is using the medication and then developing the strategies. She was diagnosed at 16, I was diagnosed at 57.

Here's a book that gives general, introductory information about treatment of ADD and ADHD, as well as other aspects of the disorder. It's probably not of much value to someone on the well versed but, for beginners, it can be a good start.

Attention Deficit Dosorder and Learning Disabilities.
Barbara D. Ingersoll and Sam Goldstein

It makesa the point, by the way, that learning disabilities are very frequently co-occurent with ADD and ADHD.

Thursday, October 12, 2006

tell them the truth...

I was presiding in a delinquency case recently and the young man was entering a plea on a probation violation. His counselor told me that he had stopped taking his meds and that this was a major part of the problem. I asked what meds he was taking and the counselor said "Concerta."

"Really," I asked. "ADD?"

"ADDHD"

"Ah," I said, "with the hyperactivity component."

"Yes," said the counselor and the young man nodded his head

"What's the dosage?" I asked.

"Fifty four miligrams," the young man said.

"you don't like to take your meds?" I asked.

He shrugged. "i don't think I need them," he answered and then he looked down at the floor for a moment. Looking up he said, "but everyone says I'm better when I take them so...so...so, I'll take them."

"Good," I said. "You know, I took 54 miligars of Concerta this morning."

He, and several other people in the court room looked at me.

I nodded. "Yes," I said. "I don't have the H component, but I sure have the A, the D and the D."

He just looked amazed.

"You wouldn't want me to be your judge," I said, "if I wasn't taking my meds."

The room was completely silent.

"Take your meds," I said.

He nodded.

I went on to pronounce the sentence for his probation violation.

it is important for the world to know that there are some of us who have grown up with ADD and have not ended up in prison or a mental institution. It's very important to struggle agains the myths.

Saturday, September 02, 2006

An Old Dresser

In my Labor Day garage cleaning I got around to the old dresser. It was a cheapie, from that famous Swedish furniture and what-not store. It was in RR's room for ten year's or so, and after a lot of hard use it was replaced. Today I took it apart, so it would take up less room in the dumpster.

It was just a matter of undoing the hold of the screws and fancier hardware then tapping the plastic covered particle board pieces so as to break the hold of the pegs that were glued between them to create the joints. Drawer after drawer I followed the same procedure; I removed the handles, placing the screws in a pile and throwing the handles, themselves, into the trash. Then I put the screwdriver on top of the freezer and picked up the hammer. A top on each end loosed the front of the drawer, which I stacked neatly to one side. Putting the hammer down I put the side and back pieces of the drawer on top of the front pieces, next to which I put the thin pieces of pressed board that made up the bottom of the drawer. Then I picked up the screwdriver and repeated the process on the next drawer.

On the third drawer I realized how methodically, deliberately, I was working, as though I had all the time in the world to get this task done. And I realized how different that was from the way I worked when I put that dresser together, a decade earlier. I worked then like I did on most assembly projects I ever undertook, like most projects of any type that I ever undertook. I did not lay the pieces out, I did not read the instructions all the way through, I did not gather the tools I would need in advance. I worked as fast as I could and made mistakes that required me to undo and redo, along the way. I was frustrated and angry when I finished, and I am sure I had several drinks which, considering how much coffee I drank that day (as I did every day, in those days) I probably would have had, anyway, that evening.

It wasn't as bad, of course, as projects I undertook in the thirties, or my twenties, or my teens or pre-teens. I had learned something from a life time of going at things, as my father used to characterize it, as though I were "killing snakes with a hoe." He also used to say that I would go off "half cocked," and that I didn't have my "head and ass wired together." Through years of bad results, and of reading a lot of self help, time management and organization books, had given me plenty of strategies to work around it, but the basic pattern was the same: I did things in an impulsive, rushed and distracted way. I did not plan, I did not prepare, I did not anticipate or think things through.

A part of why it went better taking the dresser apart than it did when I put it together has to do with those strategies. I worked hard to develop those strategies, the ways to compensate for what was "wrong with me," and those strategies have helped me to accomplish more than a lot of people who didn't seem to have the problem I do. But that was only a part of what made today's effort more successful and more pleasant. The other part was Concerta; 54 milligrams in a twelve hour, time release, tablet. Better living, as they say, through chemistry.

A lot of people have a lot to say about Attention Deficit Disorder, and about Attention Deficit Hyperactivity Disorder. Setting aside, for now, those who say that there is no such thing, some people who think about such things believe that therapy (i.e., teaching people strategies to improve performance) is the way to treat ADD/ADHD, while others advocate medication. It does seem to that each approach seems to actually work, for some people, while the other does not.

As for me, when I went through the evaluation process I learned about those strategies and learned that I had already figured them all out, on my own, right down to working at a stand up desk. Even though those strategies helped me, when I began taking medication things starting going a lot better for me.

Interestingly, for my daughter who, at sixteen, did not have a lifetime of learning from bad outcomes and so had not developed the behavioral strategies, did have a major improvement in performance with medication, but still struggles. Why? We think, now, it is because she doesn't have those strategies. She doesn't have time management and study skills strategies. But we are working on those, now.

Since I began on medication, six months or so ago, I have often stopped and reflected on what was now going on with me, as I did, today, dealing with that dresser. I have also thought that I want to share this with people who have had similar struggles, who may be still struggling. I am a success story for overcoming ADD (I do not have the H component, which is one reason it took so long for me to be diagnosed) and I want people to know that there is such a thing (as ADD and as a success story). I especially want people who might benefit from getting evaluated, or having their children evaluated, to know that it can be better than it is.

So this blog is about how it's going with me, documenting my experience living with ADD both before and after beginning this regimen of medication. I will also be documenting my daughter's experience, beginning, as she is, dealing with this condition in her teens, rather than in her fifties.

About Me

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I am a convinced Beanite Friend, a member of Bridge City Friends Meeting, Willamette Quarterly Meeting and North Pacific Yearly Meeting of the Religious Society of Friends. Notwithstanding the doubts of some who claim the name, I am a Christian who does a Buddhist practice and believes that God talks to everyone, all the time. I have worked in the judicial branch of government, as well as being a trial lawyer, a public school teacher (counselor and coach), a kite merchant, and a Marine Corp Sergeant. I am currently working as a consultant to public and private agencies on issues of child welfare, juvenile justice, and substance abuse treatment courts.