On the upside, the meds are working (still no voice, but overall I’m starting to feel less like the sort of gross wad of chewing gum that one encounters on the pavements in various places), my DanceTeam girls worked hard today today even though they couldn’t hear me and I couldn’t demonstrate anything, and I should be able to do Thursday class with BW tomorrow night,or barre at any rate.
Category Archives: meds
Right now, I think it’s fairly safe to say that we’re all a bit lost in the woods; a little at sea.
Like, all of us. The whole planet.
We didn’t really know this thing was coming, and now it’s here.
You can prepare all you like for the possibility of some global … I guess disaster is the word; it’s not the word I want, but it’s the only one that to mind. It’s a slow-moving disaster, I guess.
Anyway, you can prepare all you like, but the reality of living in it—the experience of living in it—can’t be anticipated. You can have all the stuff you need to survive and enough to help your neighbors survive, but even that can’t mitigate the shock of the sudden and utter shift, the change when the thing finally comes.
We are, whether we realize it or not, creatures of habit. When we suddenly find ourselves obliged to upend the entire normal course of our days, we kind of derail a bit.
So that’s where I am: derailing a bit, but trying to learn how to drive my train without its track. Trying to figure out which way is up. Trying to orient towards the sun and get my feet under me.
You would think that as someone whose career is inherently cyclical, with long periods of down-time, I would be more okay with this than I am.
I certainly thought that. I was like, “Yeah, it sucks that our season is over early, and that we never got to do our closing show, but it’s only a month early, really, and we’re okay financially.”
But, really, I thrive on order and ritual, and apparently the ritual for changing gears into summer mode is the last show.
Likewise, “summer mode” usually means I still go to class. It’s easy for me to forget that the thing that keeps my brain on the level is the daily litany of movement. It’s a startling surprise to remember how easily and how quickly things begin to become unbalanced.
The first week of this, D and I were in the middle of finally replacing the Camry—originally with the Electric Jellybean, but since that didn’t work out (the battery wasn’t up to D’s commute), eventually with VW Jetta TDI. That made planning my days difficult for me, so I didn’t dive feet-first into the array of ballet classes available by streaming.
Between the mental stress of the Emerging New Normal and the lack of sufficient physical exercise, my sleep quality and quantity took a nosedive.
Because the rhythm of my day was just plain gone, I kept forgetting to take my Adderall. That meant my brain was … Less able to adjust, shall we say.
Over the past several days, I slowly realized that I was starting to slip, and that it was time to do something about it. I started taking a sleeping pill early each evening in hope of getting some solid sleep.
Last night, it finally worked. I slept until 9:30 today and woke up feeling … if not bright-eyed and bushy-tailed, at least, like, eyed and tailed. You know. Basically equipped to more or less function.
I remembered to make myself a cup of coffee: it’s become part of my morning ritual, and one that I enjoy. It helps my brain know that there’s a day happening and we’re going to go do the things. I remembered to take my Adderall.
I’m late getting started, but once I finish this coffee and this post I’m going to go take class … albeit, in my living room, and probably in socks. When I’m done with that, I’ll do my assignment for the company, because I’d like to still have a job when the current storm blows itself out.
I’m not going to sermonize or tell anyone how to handle this crisis. We’re all grieving, and grief is a deeply individual process.
Nor am I going to confidently assert that I’ve got this handled, now: I’ve only got this present moment handled, and if things start to derail again, I’m going to try to give myself in una poca de gracia, as the song says.
- The song, of course, is La Bamba, which arguably has nothing to do with any of this … Except doesn’t the line, “To dance the Bamba, it’s necessary to have a little grace,” rather beautifully describe how to cope with a sea-change like this one?
- Dancing, after all, is just falling and catching yourself, over and over, until it looks beautiful.
I’m going to remember the tools I’ve learned to use over the past few years. I’m going to:
- do two things
- grant myself grace
- take my Adderall
- and last, but not least, take class.
Going forward, I’m sure I’ll make some mistakes. That’s okay. We humans are makers of mistakes, but also makers of magic and music and beauty and art.
We’ll get through this, and we’ll find north again.
And until then, we’ll stay home and remember to wash our hands.
Oh, and since I wouldn’t be me without a little irreverent humor, here:
(File under: Every Aphorism I Know I Learned In Bike Racing)
I’ve been having a tough time with re-entry following this summer’s intensives.
Not that I’m, like, pining for the fjords. Just…
Hmm. How do I explain it?
Going to a dance intensive is, in a way, very much like going to summer camp. You’re essentially excused from most of the responsibilities of adulting. Your daily activities are heavily programmed for you. You don’t have to juggle variables, interruptions, or random transportation disasters.
If you forget your ADHD meds, you make it through the day pretty well because all you’re doing, really, is dancing, and your brain works best when you’re in motion. You don’t have to remember a bunch of discrete, unrelated tasks and somehow accomplish them.
If you stay up really late bonding with your new dance family, it’s no big deal. You get up the next day, pour some strong coffee into your face, hit the studio, dance your butt off, and sleep like the dead when you get back to the dorms or your AirBnB.
And then you come home, and your body is adapted to an 8-hours-per-day-plus physical workload that you’re unlikely to match except during the most intense periods of rehearsal or performance, and you have to get back to Adulting (with or without ADHD).
For me, this illuminates one of the central challenges in living with ADHD: it never goes away.
To borrow a quote from Kiwi bike racer Greg Henderson :
- or a quote about success from Robert Strauss, who presumably doesn’t race bikes but could feasibly be a Kiwi; can’t be arsed to look him up right now.
You don’t stop when you’re tired. You stop when the gorilla is tired.
ADHD is, in some ways, a gorilla that never gets tired. Instead, you have to learn to manage your gorilla—and managing is largely a question of automation.
When I’m doing it right, I manage my ADHD by making it as hard as possible for myself to screw up the basics.
I lay out each day’s clothes the night before, so I never have to fumble around looking for clothes before my brain is working.
My morning and afternoon doses of Adderall are right there in my 7-day pillbox, so I don’t find myself thinking, “Feck, did I take my meds?”
My keys, wallet, sunglasses, and other important small things live on a shelf by the door, so I will always put them there when I walk in and never have to wonder where they are.
My phone lives next to the bed, where it acts as an alarm clock. Once I get out of bed, I either leave it tethered to one of its chargers or keep it nearby. That way, I never have to look for it.
My class and rehearsal schedules get written out on the whiteboard on the refrigerator door. Writing them down helps me remember what’s coming up; it also gives me a hard-copy reference when I’m not sure and lets D know where I am, when.
While I cook, I clean as I go and streamline general dishwashing into those moments when there’s nothing that requires attention.
I run errands before, after, or between classes so I won’t have to take extra trips out of the house. I maintain shopping lists on Google Keep so I don’t have to remember anything, including the shopping list.
I burn a ton of energy, knowing that it’s the only way I’m going to be able to sleep on anything resembling a normal, diurnal schedule. I run Twilight on my phone and f.lux on my PCs to cut out blue rays (this really does make a huge difference, for me). I don’t play video games or peruse social media in bed, because those get my brain ticking over too fast.
I pay really close attention to things like caffeine intake: and if I’m having a rough time sleeping, I avoid any caffeine at all after about 2 PM.
These are all fairly small things, but they add right the heck up.
The problem is, they’re all routine-driven, and once I get out of a routine, it can be really hard getting back in.
This week, I’m struggling really hard with insomnia. After being sick for most of last week (during which all I actually did was sleep), I’m left with a surplus of energy, but not enough on the schedule to burn it off.
Since it only takes one sleepless night to torpedo weeks of careful sleep programming, I’m currently in the midst of a really unpleasant cycle of sleeping two hours one night, then nine the next.
Last night was one of those two hour nights. I missed class today because of it: I finally got to sleep around 8 AM. Turned off the alarm at 9 AM, when I realized it would be foolish to try to do modern on one hour of sleep. Woke up at 10, when I should’ve been starting class, anyway.
I’ve realized I need to get back to negotiating with my gorilla. I’m home for one more week, then off to That Thing In The Desert after all, then back for a week, then off for a medical thing, then possibly starting rehearsals for a thing, depending.
- In addition to the usual Open Barre sessions with mimosas, I’ll be leading some contact improv playshops at our camp this year.
- I’m going to apply my “to know, to will, to dare, to keep silent” clause here. This is a minor medical procedure but a huge freaking deal for me, so I’m trying not to feck it up.
- Here, too. I’m actually okay with waiting and auditioning for the next thing this company does, but it’s sort of up in the air right now whether we can work around my temporary restrictions after The Secret Medical Thing.
None of this makes it easier to figure out where to start rebuilding my Life Management Protocols, so I’m just going to do what I normally do: fumble forward and hope for the best.
In other words, just pick something and start where you are.
In that vein, I’m hoping to get a class in tomorrow to make up for missing today’s (though tomorrow’s class will be ballet, not modern).
I’ve got a doctor’s appointment at 8-o-freaking-clock in the morning for which I have to check in at 7-goshdarn-30, which means getting up at 6-what-even-is-sixthirty-30 because I kind of need D with me for this one and he needs more than 20 minutes to get out the door 😛
As such, I need to actually get my tuchas in bed at a reasonable hour tonight and, if necessary, hit myself with a whacking great dose of doxylamine succinate to make sure I don’t stay awake all night.
Those are some easy start-where-I-am steps that I can actually do (along with getting audition video links to the AD for the Secret Dance Thing and signing some documents for The Secret Medical Thing and emailing them back to the practice in question).
So, there you have it. I think I really wanted this post to be more of a thought-piece about managing ADHD than me scrabbling on about how I’ve managed to hose everything up for myself (though I did plan to mention that), so I suppose I’ll add that to my queueueueueueue of posts to actually write sooner or later as well.
Until then, I’ll be here, negotiating with my gorilla.
Oh: in other news, I successfully gave a bit of advice to a new guy in class last night, which felt really good.
Since I am, by nature, a giant show-off, I joined a detachment of my fellow ballet peeps in the Pegasus Parade yesterday.
Although the weather was drizzly and blustery, the parade was fun. Even the standing-around-for-three-hours clusterfeck was reasonably fun, since I was standing around with BG, T, C, E, AB (our in-house yoga teacher), and, um, the one girl whose name I for some reason can’t remember (apologies!). We kept each-other entertained with snark, irony, and occasional earnest conversations about what we’re doing with our lives.
After a while, myAdderall wore off because I forgot to my second dose for the day, and I remembered an important equation:
me – Adderall + standing around with nothing to do^(enough time) = idiocy
Fortunately, I did not (seriously) injure anyone with my giant umbrella. I miiiiiiiight have gotten a little too enthusiastic during a bout of umbrella fencing and poked BG in the chest (regarding which: I should probably not be allowed to have a giant umbrella until I learn how to keep a lid on things 😦 ).
The parade itself was 17 blocks of ballet walks, waltz turns, random partnering exercises, spasms of grand allegro, and occasional yoga.
My foot did not make it through without getting sore at all, but it only got a little sore.
After, I booked it to BW’s class.
Have I mentioned that I ate lunch at 11:30 and then completely failed to eat anything until after my haircut, which finished up at 9 PM?
BW’s class, truncated, was an hour of barre, slow but not easy. By the end, my feet didn’t want to point and my left leg basically argued my about brushing into an arabesque above 70 degrees and then folded into attitude on what was supposed to be a an arabesque in plié. BW said, “Let’s callgood it a day and stretch—you probably haven’t eaten since lunch, have you?”
And then I realized that, yes, I knew this feeling. It was Ballet Bonk again. Evidently, BW is great at spotting Ballet Bonk.
So we stretched, and I asked BW to snap some pix for this month’s Suspend Challenge.
It’s Splits Time again, so here you go:
… Or, okay, yes, but really only whinging a bit 😉
I saw the nurse-practitioner (you guys, autocorrupt suggested MURDER practitioner! W… T … Actual … F?! o_O’) at my doc’s practice today.
She confirmed that I have a sinus infection and also a wee ear infection, which explains why it sometimes feels like the spirit level in my head is borked.
I’ve been handling this thing very conservatively — actually resting basically all the time, staying clear of strenuous activities (except for the part when I decided to be helpful and uninstall two of the three window aircons in the house by myself, which I did successfully, but which knocked me onto my backside). On the balance, I think it has paid off. In the past, my sinus infections have often progressed into bronchial infections by the end of a week and change, so the fact that this one had constrained itself to the confines of my head is comforting.
I’ll be taking doxycycline for a week and I’ve got a script for plain 12-hour psuedoephedrine for a while, so that should get me sorted and back to the studio.
I may attempt Killer B’s barre tomorrow, but I may not. It really depends on my balance and energy level. Today I am definitely listing to port (and not just politically speaking, though I did go and vote), so that’s a huge if. I might also hit up Trap 3 tomorrow night as a semi-spectator, but I don’t want to pull out all the stops right away. I have figured out that easing back into things is part of the deal for me.
On the upside, my blood pressure was stellar (110/56) and my heart rate was fine (75, which is lower than it often is in doctors’ offices, because I am still mildly stressy about being in them, which can be weird and hard and awkward if you’re an intersex person).
So things look doable.
Now I’m going to lie around and watch stupid movies and otherwise bury my head in the sand until the US General Election is over, at which point my friends will tell me whether it’s safe to come out or I should start burrowing a tunnel to Canada. Except by then I’ll probably be asleep.
In other news, I’ve been reading horse blogs, which reminds me how much I miss having horses in my life, which is why I avoid horse-related content.
Advanced class was pretty good this morning, once we all thawed. I remembered to eat and to take my Adderall, so it was easier to focus when Ms. T was giving the combinations.
Cirque classes were meh — I burned the palm of my hand the other day while retrieving a pizza from the oven and the blister tore and peeled off, so we struggled to find a way to compensate for that. Juggling wasn’t too bad, but Vertical Variety was a challenge. I wore Denis’ work gloves, which kept the wound from getting any worse, but made doing things awkward. I’m not normally prone to any degree of fear on aerial apparatus, but kept feeling alarmed because I couldn’t grip the dance pole. Weird.
My blood sugar tanked by the end of the second class. When I got home, I tried to make a sandwich, burned it, and completely flipped out. Afterwards, Denis made me feel better. I can’t express how much that means to me. I have come to understand the value of comfort; the importance of a warm pair of arms to hold you together when you feel like you’re flying apart from the inside of.
I’ve decided to talk to my GP about possible ways of dealing with my hormonal fluctuations, which are exacerbating my bipolar symptoms. That’s one thing I can do without disastrous side-effects, and hormonal therapy did help in the past.
I may see if I can switch to a controlled-release ADHD medication for a bit, because I’m having trouble remembering to take my pills.
In other news, I heard back on my Columbia application today. Not good news, but it’s not the end of the world (yes, to some extent, this is me keeping a stiff upper lip). I need to finish my other applications; if I don’t get accepted into a program, though, I have other irons in the fire.
Regardless, a rejection letter from any other program wouldn’t sting as much: in short, I’ve never received one before. The first is the hardest.
So that’s that. I’m going to go cook myself in the tub now.
Yesterday was a bad day: a very bad day. The kind of day on which the depths of my disorder are somehow visible to the general public; the kind of day on which sensitive people ask me if I’m ill. The kind of day on which, for whatever reason, bipolar reveals itself in enormous dark circles under my eyes.
It was the kind of day on which the thought of talking to people is nearly unbearable — at once repugnant and frightening, since I can’t trust myself to speak in a way that doesn’t reveal the magnitude of my debility; on which I feel the fear the injured alpha wolf must feel — that my weakness will be revealed and I will be torn apart.
The kind of day on which I am wildly paranoid in an inchoate kind of way, but still rational enough to know that I am paranoid.
Yesterday’s venture deeper into to the dark and tempestuous waters of mixed mania was almost certainly precipitated by the use of a sleep aid the previous night. It’s a counter-intuitive outcome, but one I’ve experienced regularly. For some reason, antihistamines do things to my mood.
When I’m fairly euthymic, they render me a little groggy and down the next day; when I’m in my current state — skating desperately along the knife’s-edge of mixed mania — they’re a potentially-disastrous crap shoot.
The sleep-inducing medication in question is an antihistamine.
I seem particularly prone to the adverse effects of antihistamines, anticonvulsants, and other sedation-inducing medications — in short, depressants. Alcohol can also induce deeply unpleasant and even dangerous mood-states after its pleasant effects have worn off.
I would conjecture that I’m also unusually prone — relative to non-bipolar people — to the effects of stimulants, but I rarely experience those with the immense dysphoria typical of my reactions to sedatives.
Sedatives combined with stimulants, meanwhile, are a recipe for a day in Hell (whereby I probably should’ve skipped the iced coffee I had with lunch yesterday).
Yet, there comes a point at which one must decide whether the risks of a sleeping pill-induced bad day are worse than those of continued insomnia.
The after-effects of the sleeping pill, presumably as my brain attempts to re-regulate itself, wear off in a day or so if I don’t take another one. It is possible to get through one very bad day with a little help.
The effects of insomnia, on the other hand, will continue to accumulate and self-amplify indefinitely, until the current manic episode passes — and it is difficult to predict when they’ll jump the track and become manifestly dangerous. Worse, manic insomnia tends to beget manic insomnia — the less I sleep, the less I sleep — which induces further mania.
This is, perhaps, the heart of the problem with bipolar disorder: beyond its often-disabling nature, beyond the fact that non-bipolar people seem literally (and, perhaps, understandably) unable to comprehend what it’s like, it carries with it an immense sensitivity to all the factors that influence brain chemistry — including the very medications we use to treat it.
Worse still, perhaps, it is associated with great creative gifts — but also with the inability to utilize those gifts.
Bipolar disorder disrupts the ability to do sustained, concentrated creative work (or uncreative work; it may be even worse — the “worstest” — for that!).
The medications we take to counter the destructive aspects of bipolar, meanwhile, are equally capable of destroying both the creative faculties and the ability, physical and/or mental, to exercise them.
Lithium alone is associated with micrographia, Parkinsonian movement disruptions, and disturbances in balance and equilibrium, to name just a few of its adverse effects. For visual artists, dancers, and musicians, it can be devastating. Worse, these effects do not always ease up (as is often the case with other medications) as the brain and body acclimate: instead, they are often cumulative and even progressive.
In some cases (the tardive dyskinesia and akathesia associated with antipsychotics; the thyroid disruption associated with lithium), they become permanent: they will remain, perhaps treatable but generally incurable, even if the medication is stopped.
Artists living with bipolar find themselves trapped between hammer and tongs. The immense sensitivity that informs our work is at once fed, imprisoned, and subjected to danger of execution by the firestorms that rage in our brains and minds; when we bring in the fire crews, however, the ensuing flood too often downs all but the mere ability to keep body and soul together. Too often, the ability of the soul to soar is not preserved, nor even the ability of the body the function as it once did.
I have no useful advice to offer, here — just frustration to vent.
The question that all of us who live with bipolar disorder always face is this: are the costs of this treatment worth the benefits?
For many, the answer is a resounding yes — for many more, a qualified yes. For others, though, the answer is no, or not really, or I feel trapped; there is no right answer, here.
Too often, practitioners and caregivers still treat those of us for whom the existing medical therapies are not acceptable bargains as recalcitrant children who do not know what is best for us.
Sometimes, of course, they’re right — bipolar is a disease that does not want to be medicated, and sometimes it’s the disease talking; likewise, in our most florid moments, we bipolar types aren’t always rational.
However, I don’t believe that should be the first response. When an apparently-rational patient says, “I have tried these medications, and the side-effects were untenable — what now?” a practitioner would do well to listen, to consider alternatives, and — if need arises — to make a referral to someone else who may know if another strategy.
And always, always — even when we are manifestly mad, with all the attendant indignity of madness — patients should be handled with dignity and tact.
By way of illustration, there can be no doubt that lithium, in particular, saves lives.
So, however, does penicillin — and we find other ways to treat people who respond adversely to penicillin. We don’t criticise them or treat them as bad patients.
We who are or who hope to become practitioners would do well to keep that very simple example in mind.
When we express contempt towards mental illness patients who can’t tolerate the usual medical therapies, when we treat them as misbehaving children or miscreants, we are really expressing deep-seated cultural prejudices. Also frustration, of course, but that alone really doesn’t explain it; a doctor, PA, or NP may be frustrated by a patient’s inability to take penicillin, but that frustration isn’t generally expressed as contempt.
Instead, penicillin sensitivity (especially when severe) is generally met with compassion — It’s too bad the simple and inexpensive option doesn’t work, let’s see what we can find that will.
I know this because I, in fact, can’t take penicillin. I’m deathly allergic to it.
I am not, in fact, likely to die from lithium use, and I’m willing to use it as a short-term intervention should things get really, really out of hand. I am not, however, able to tolerate is effects over long-term treatment. The same can be said for antipsychotics.
I do the best I can to manage without — and I continue to research and seek and hope for an alternative. I also realize that, for me, a medical alternative may never appear.
I continue to understand that my current strategy may not always be tenable, either — that sometimes bipolar disorder gets worse with age, and that a day may come when I am no longer able to manage as I currently do.
Right now, the lesser of the two evils is bipolar: someday, that may not be the case.
If that day arrives, I may have to strike a different bargain. Bipolar, in the end, is the mother of many bargains.
Until then, I will struggle to make the most of my creative gifts, knowing that someday I may not be able to use them.
Until then — and indeed, thereafter, should that day come — I will continue to be immensely grateful for the fact that I have health and mental-health practitioners in my life who do not regard my decision to eschew long-term medical therapy with contempt, as the foolish decision of an irrational child, but rather with compassion, as the careful decision of a rational and intelligent adult.
That is an immense privilege; a great gift.
It is also a reflection of privilege: I am white, male, of “normal” size, well-bred, well-educated, and well-spoken. I am married to a medical professional.
Doubtless, all of these things factor in the quality of care that I receive — when none of them should. All that should matter is that I am a human being, and thus deserving of respect even when I’m irrational, stubborn, and wrong.
This, ultimately, is what every single person with mental illness deserves — even when we are irrational: respect. The essential respect of one human being for another.
This is basic human dignity in action.
It should be neither a privilege, nor something we stumble upon by luck.
Today I am feeling restless, grumpy, and depressed.
A week without dancing will do that to you.
…Or, well, not entirely without. I practiced turns in the kitchen and did a bunch of random ballet stuff all over the house (I’m suddenly really into développés, balancés, and sauts de Basque, though the last of these I can only do very cautiously in our living room). What I didn’t do — though I should have – was give myself a progressive class of at least an hour’s duration at least twice. Or, like, I might have at least done one of those ballet-centric workout videos.
Today I plan to do laundry, loaf in bed, indulge my depression (and my cat, who is only too happy to have a People hanging out in bed), and write.
Tomorrow, it’s back to the studio with me, and about demned time. I am quickly becoming intolerable (though I think it’s cool that I am beginning to have insight into this process, instead of merely feeling as if it comes out of nowhere).
I sometimes sort of apologize for this, when I explain that I use ballet as a kind of medication. I imagine that people will think, “Well, you’re not all right all the time, so clearly it doesn’t work.”
I forget that psychopharmaceuticals mostly must be taken every single day,and that if someone concluded that psychopharmaceuticals don’t work because the effects wear off if you stop taking them, I would patiently explain that they do not cure, but only treat, bipolar disorder, which is a chronic condition.
I do best when I can take class as close as possible to every single day, just as I would do best on a drug therapy* if I took it every day.
It’s not that dancing doesn’t work: it’s that, like drugs, it’s not a cure. Like drugs, it rather holds a relentless disease process at bay; maybe even drives it back a ways — but neither dance nor drugs effect a cure. Neither can eradicate the disease process entirely. Cease treatment, and the machinery of the disease will shudder to life again, and sooner or later symptoms will arise.
When I take a “drug holiday,” as it were, from dancing, the disease process is able to advance just as it would if I were taking lithium** and stopped that. Likewise, just as there are other drugs that can approximate, to a greater or lesser extent, the effects of lithium, a break from dancing may be mitigated by the substitution of suitable physical activities: a great deal of walking and/or swimming, for example, can keep me on a reasonably even keel — but those must be taken in doses of hours per day if they’re to work, just as different medications may have different dose effects. Running and cycling also work — better (and thusly at somewhat smaller doses) than walking and casual swimming, but still not as well as the intense rigors of ballet class.
So there you go.
I am grateful that there are such things as blogs. In moments like this one, I withdraw from reciprocal socializing — but it is helpful to know that I can write, “I am having a bad day” and that there is a public record of it, even if I can’t always lay that burden at the feet of my loved ones.
I am intensely introverted when depressed, and the outlay of energy required to initiate and sustain a social exchange seems dauntingly high. Blogging seems to offer some of the benefit of doing so, but at a greatly reduced cost.
* The analogy that follows doesn’t extend well to Adderall for ADHD — Adderall has a very short half-life and doesn’t necessarily produce any changes that outlast its therapeutic window, while both dancing and lithium arguably do. Adderall doesn’t arrest the disease process of ADHD (if, indeed, we even use “disease process” as a model — where ADHD is concerned, it’s not a very good one). It simply mutes the symptoms to a greater or lesser extent until enough has been excreted that the therapeutic threshold is no longer met. As such, I’m disregarding my very effective working relationship with Adderall, here.
** This is, in fact, a poor analogy in my case: lithium is an immensely valuable tool for many, but for some of us, the side-effects are disabling; I was far more disabled on lithium than I am off of it. Worse, I was unable to dance or to do creative work, without either of which I can’t feel whole. It’s still something that is, for me, a medication of last resort, to be used only temporarily and in extremis.
I eschew routine treatment with lithium not by choice, but by necessity.
Last night, I streamed Fauré’s Requiem and scrubbed the ceiling fan in the kitchen.
I could, realistically, have spent the time sitting on the couch and chillaxing, but cleaning the ceiling fan sounded more interesting. I had already spent nearly four hours sitting down to watch an opera, after all.
The Great Polishing of the Fan took an hour. The thing was filthy, coated with who knows how many years of aerosolized cooking grease (probably not that many, though, because Denis doesn’t cook — before I showed up, he ate out a lot). I worked steadily, singing. The cat supervised, as cats are wont.
While I was cleaning I realized that it’s been a long time since I’ve been able to conceive of starting a project like that, let alone of getting through it without feeling like I was going to explode — like, seriously, since before the summer term when I scheduled two intense classes for one six-week session and completely cracked afterwards. Even back then, I did a lot of starting things and then getting overwhelmed.
It feels weird to be able to simply finish things. This is not something that has ever been all that possible for me. It’s weird to just come up with a project and bang away at it ’til it’s done. It’s equally weird to be able to walk away from a project, come back, and pick up where I left off without first spending half an hour remembering where, precisely, that was in the first place.
It’s a good kind of weird. Slightly jarring, in the way the first year or so of my relationship with Denis was: this sense of always waiting for the other shoe to drop; waiting for it all to go off the rails. So far, things seem to be under control.
Working on catching up all the leftover projects has made me realize exactly how tough last year was for me. It’s strange, because there have certainly been years that I would have described as, perhaps, experientially harder — but last year, I was clearly not functioning so well in a lot of ways. A lot of stuff took a back seat.
In the long run, that’s probably a good thing. I’ve spent most of my life driving myself pretty hard (and, sadly, often to insufficient effect), and while perhaps screwing up your finances and horribly neglecting vast swathes of domestic responsibility aren’t the best way to do it, sometimes a rest is needed.
This is one of the major problems with American culture: we seem to think that if work is productive, even more work will always be more productive — which is not, in fact, at all the case. Our culture and our economy are structured in such a way that restorative rest is rarely possible, and yet they’re actually essential to being happy, healthy, and productive. This is doubly true for those of us who live with mental illnesses.
I’ve heard it said that mules are smarter than horses, because a horse will let you work it to death (caveat: not so sure about some of the horses I’ve known!), while a mule will simply up and stop when she’s good and done, and no amount of haranguing will convince her to do otherwise.
Part of me wishes I’d bitten the bullet and hopped back on the ADHD meds sooner. Part of me recognizes that, if I had, I probably wouldn’t have addressed some stuff that needed addressing. I guess I needed to kind of fall apart to realize that I couldn’t just hold the universe together by force of will alone, and that, in fact, it’s okay not to be able to do that.
Zen focuses a great deal on the idea of no control — that, really, control is an illusion; that efforts to grasp it are futile. Last year was one hell of a good example. Not to say that it was entirely a wash — I had some great experiences last year; ones that are now driving the forward-going direction of my life. But I definitely took a lesson in how illusory control really is.
I’m still having trouble initiating tasks that involve sitting down and using my brain instead of standing up (or, as I did this morning, crouching on the floor) and using my body — writing excepted. In theory, increasing the dose of my medication might help with that, but honestly I don’t really want to do that.
I’d rather see, first, if I can build that skill through experience. Right now, it’s hard for me to start those tasks in part because I associate them powerfully with frustration and failure. This is why I can muscle through the “sitting down” part when I need to do homework, but not always when I need to work on the filing or the finances.
The thing is, I’ve managed to undertake quite a few onerous sit-down-and-brain tasks in the past couple of weeks. While starting is still quite hard, I’ve found that I’m much better at finishing them now — and generally without gaining a splitting headache for my efforts! Cracking out two months’ of financial catch-up in the course of maybe four to six hours was huge. Huge. In the past, that would’ve taken a solid two days — and it would’ve been a thousand times more miserable.
Denis has apparently been pretty impressed with how things have been going for me as well. On Wednesday, I went and got my hair cut by myself. This was the particular thing that felt like a real signifier to him: the thing that he focused on when we were talking to my therapist this week. He mentioned a couple other things, but he kept coming back to that point — in part, I suppose, because it involved making a plan to do a thing I don’t usually do by myself, then executing that plan successfully. This, from the Boy Who Doesn’t Plan.
Getting a haircut by myself really is kind of a big deal in my world, since getting my hair cut is something I have historically found highly stressful for reasons I don’t quite understand. I also figured out how to communicate what I was looking for to the stylist, who in turn did a fantastic job implementing it — so there’s another reinforcing experience.
So, in short, as I build positive associations with sit-down-and-brain tasks (and others that I find stressful, like getting haircuts), I think I’ll find it easier to initiate them. Meanwhile, I’m finding that I tolerate Adderall quite well at the current dose, and being that I’m very prone to developing side-effects (though far less so with stimulant meds than with those that involve depressant mechanisms), I think I’d rather not tinker with it right now.
At the end of March, I have another appointment with Dr. B to check in about the meds. Unless she feels very strongly that my dose should be increased, I think I’m going to request that we keep it right where it is.
I don’t think medication is a magic bullet for me (it might actually work that well for some people, and that’s great). It does, however, work rather better than I’d hoped — and I find that I don’t really want a magic bullet, anyway. I want to be functional enough. That’s it. And I think I’m getting there.
So that’s it for now. Back to preparing all the paperwork and so forth for our meeting with our accountant.