I’m writing this mostly as a reminder to myself, since managing widgets on an Android device is kind of a PITA and I’m not in front of my laptop right now.
Anyway! I’m planning to add three resource widgets: one with resources for autistic peeps, one for ADHD peeps, and one for Ehlers-Danlos info.
Each will include links to websites I’ve found really helpful, and that I hope might be helpful to anyone else who’s trying to navigate that neurodiverse lyfe or that bendy, poppy, sometimes dysautonomic lyfe.
I thought about lumping the ASD & ADHD resources into one “Neurodiversity Resources” widget, but A] that could turn into one hella long list and B] breaking them out into two separate widgets might be useful for anyone who’s looking for one topic or the other specifically. Also, I find it deeply satisfying to sort things into categories, because autism.
That said, there is often a lot of overlap between ADHD and ASD, and I hope y’all will feel free to explore any resource that sounds like it might be useful.
ASD is also more common in people with EDS than in the general population, which is both fascinating in terms of research potential and a huge relief to people like me who have spent our entire lives wondering if we’re really just gigantic hypochondriacs (even though EDS is diagnosed by objective physical criteria and we chime right along with the diagnostic profiles for ASD & ADHD and have carried both diagnoses for most of our lives).
I’ll also add a Resource Room page—that way, folks can find the resource lists in an uncluttered context.
Lastly, because I’m a nerd who likes to review things and who recently received the gift of a Costco membership, I think I’m going to try doing a wee video series reviewing stuff I’ve stumbled upon at my Costco that has proven really useful in my life as a neurodiverse dancer currently struggling with the scheduling chaos related to the ongoing pandemic. SPOILER ALERT: it’s mostly gonna be food.
- Autocorrupt suggested, “…ongoing Patricia.” Patricia, I don’t know you, but apparently Autocorrupt thinks that you’re the one sowing chaos in my daily life 😱 Don’t worry, though—Autocorrupt is almost always wrong. Almost always. But if it is you, can you take it down a notch, please? 😅😅😅
I have been wrestling a sinus infection, one of those opportunistic tagalongs that grabs hold on the wake of a brief-but-fierce virus. Thus far I’ve been trying to wait it out: but while the initial fever has abated, the lingering congestion, drainage, pharyngitis, and fatigue have pretty much convinced me that resistance is futile and a trip to the Immediate Care place is probably in order.
Throughout all of this, I’ve been prying myself out of bed to get to class and rehearsal. It’s just what you do. If I was still running a fever, I’d stay home to avoid infecting the rest of the company: in a company this small, two or three dancers out sick is practically a massacre.
I’m not feverish, though, so I gather my gumption and go.
It occurred to me this morning (a blessed reprieve, since the company isn’t called until 2 PM) that I wouldn’t do this for a desk job.
In fact, I couldn’t. Being still and concentrating is an enormous challenge when I’m at my best. Right now, it’s impossible.
At the ballet, I can mostly keep my head together when I’m moving, and when I’m not needed it doesn’t matter as much if my brain clicks itself off for a while. I can be a zombie on the sidelines, passively absorbing as much as I’m able to, until I’m needed on the floor again.
I don’t think I would’ve figured this out if I were working a desk job. I’d just have known that other people work through non-contagious illnesses that turn me into a zombie. I couldn’t have figured it out, because I wouldn’t have had the necessary data.
Think of me as a kind if intellectual shark: if my thought process is to live, I have to keep moving. At the best of times, micro-movements and occasional breaks to get up and walk around can do it. If I’m sick or sleep deprived, though, I have to really move to pass enough water over my metaphorical gills.
Driving is the most stressful part of my day right now: too much bodily stillness as the body and its protective shell—a missile that weighs a literal ton—hurtle down the road at around seventy miles per hour. Keeping my brain out of screen-saver mode is far harder than usual even with Adderall.
But I’m getting through it. After the intense mental burden of the drive, I manage all right at the ballet.I
And this is new information, and valuable: it’s not that I’m somehow weaker than my fellow desk-jockeys were when I worked at a desk. It’s that I need different inputs.
So that’s that. And now I need to go gird my loins and enter the fray. The dance, after all, isn’t going to rehearse itself.
I’ve been working on a strategy for combination-acquisition that Modern T recommended to me, and I really think it’s probably the best way to go.
In short, instead of hand-miming or subtly marking the combo as it’s handed out, you just stand (or, in some cases, sit) there and watch — really watch and ingest; get a good, solid mental video.
Then, if there’s a repeat of the demo or a verbal explanation, you can mime or mark as needed. It also helps to program in the counts (and swing and swing and swing and around, or what have you) on the repeat if you think you’re going to get lost.
This approach prevents you from missing critical points — the direction of a turn; what exactly happens during a change of direction; whether there’s an extra step or a direct weight transfer; what’s happening with arms and necks and shoulders and backs.
I did this throughout most of class today. Sometimes it felt really weird to be standing there just watching while much of the rest of the class was doing the subtle-marking method and my brain cells were firing like crazy, trying to make parts of me move.
On the other hand, it worked.
Throughout much of the class, I had the choreography down about as well as anyone. I felt solid doing it, even though sometimes my body was busy going, “WTF, THIS IS NOT GOOD BALLET, I WANT TO DO GOOD BALLET.” Sometimes my body doesn’t get the memo that modern != ballet.
To be frank, this kind of watching is hard for me. I tend to space out (and then start jiggling) when I’m standing still (thanks, ADHD!) — so this kind of “just watching” involved a very conscious, intentional imbibing*.
I totally failed to apply this lesson going across the floor. I started out with good intentions, but then realized I was in somebody’s way, took a step — and suddenly I was soft-marking along and missing really critical elements (Wait, isn’t there a third triplet? And is that hop-tour lent thing on the upstage leg or the downstage leg? And why am I doing it as if it was an sauté-fouetté?!).
As such, my across-the-floor combination was a straight-up disaster.
I did it wrong, then did it another flavor of wrong, then did it a still another flavor of wrong… Literally every pass (and we did the combination at least four times each way) was a new, unique, and different kind of more-or-less entirely incorrect.
Yeah, I got a bit frustrated, there. Like, seriously, for once in my life, when Modern T said, “Do you want to do it again, or are you guys done?” I was the one who said, “I’m done.” (And then did it twice more anyway.)
But, at any rate, I learned a valuable lesson about how I absorb choreography (and, um, knowing is half the battle, I guess?).
Moving right along.
Some thoughts I’ve been kicking around with G+ friends have led me to reflect on my eating patterns, and I’ve realized that I eat quite differently for a strongly dance-based lifestyle than I did when I was training for bike racing.
I’m not at all sure I’m Doin’ It Rite™, but — at any rate — I’ve noticed that dancing doesn’t seem to make me as hungry as cycling (I think I’ve touched on this before) and that my “fueling” strategy is quite a bit higher in carbs than it was for cycling.
Some of this, of course, is sheer disorganization. I have not adapted amazingly well to my current schedule, which often involves dance classes in the morning, a brief break in the afternoon, and aerials or more dance classes in the evening.
Basically, I am not good at changing gears, and thus am not the kind of person who can get much done in the gap — so I do less cooking than I should and more, well, scavenging for anything quick, basically.
I have at least finally managed to mostly get on top of breakfast, for the most part. Breakfast is usually ~113 grams of plain Greek yoghurt, ~70 grams of unsweetened frozen berries (I happen to particularly like the blends that include cherries), and 25 – 30 grams of whatever kind of not-super-sugary granola looks promising.
If this sounds astonishingly precise for me, I promise, it’s really a function of the fact that it’s easier to scoop yoghurt out with a spatula, weigh it, and hit “tare” a few more times as more things are added than it is to shove it into a measuring cup, then transfer it into a bowl or whatevs.
I also have fancy yoghurt bowls that keep the crunchy stuff separate until you’re ready to eat. Using frozen berries means I have to make the yoghurt parfaits ahead of time, which saves me from having to fumble around with the kitchen scale in the morning.
On days that I fail to crawl out of the crypt bed in time to actually eat like an adult (or at least a toddler), I still tend to desperately chug protein shakes on the way to class. For such emergencies, I use Orgain (Creamy Chocolate Fudge) because it’s low in sugar, decent in the fiber department, tastes okay, and isn’t horribly expensive. My base of choice is unsweetened almond milk, but it’s perfectly good with regular milk. I usually add coffee concentrate and a touch of vanilla extract, but it’s acceptable without.
Dinner is frequently some species of pasta — I’m particularly fond of ziti and penne rigate — because I can make that ahead in huge batches and reheat it later. My sauce of choice comprises an “Italian seasoned” tomato paste, a ton of diced tomatoes (usually canned, because laziness), basil, oregano, garlic, onions (sauteed in a little olive oil and red wine), sometimes mushrooms, and either meatballs (sometimes frozen, sometimes turkey) or sausages.
This makes it sound like I plan better than I do.
If I were really any good at planning, there would be far fewer nights on which we eat dinner at 9 PM when I’ve arrived home at 7:45
Interestingly, I almost never ate pasta when I was racing bikes (except when I was intentionally carb-loading). Training rides tended to make me insanely hungry and I would just go crazy with the pasta; I generally substituted raw cabbage for the actual noodles (the sauce heats the cabbage just enough to be crisp-tender, which is awesome).
I’m much better, now, at figuring out when I’m full, so I actually do eat pasta. I still often add either raw cabbage or raw baby spinach, though (because veggies ftw).
In the past, my breakfasts were also generally lower in carbs than they are now.
Meanwhile, lunch is just a horrible, ongoing, unmitigated disaster of food-on-the-fly right now. How desperate my choices are depends upon how well I’ve walked that fine line between just enough breakfast and way the hell too little breakfast*.
I am not too proud to admit that I lunch has recently featured such stellar choices as a fried chicken sandwich, half a Whopper (apparently, I can’t eat an entire Whopper), or pizza from a gas station’s convenience store.
This doesn’t really seem to be making any impact on my baseline health statistics (if anything, it’s the only thing stopping my blood pressure moving from “low” to “undetectable”), but it probably does significantly impact my ability to not be a horrible, face-eating hypoglycemia monster by the time my evening classes roll around.
So basically, in summary:
When I raced bikes I was hungry all the time, limited my carbs, and was much better at lunch.
Now, my appetite is more manageable even though I burn roughly the same number of calories on any given day (if not more, because I have more upper-body muscle than I used to — so, seriously, wtf), I eat pasta like it’s going out of style, and I am terrible at lunch.
The next step, then, is to figure out how to eat lunch on the fly without spending a gajillion dollars. I mean, obviously, I know how to eat lunch (open mouth, insert
foot food), but the question is how to plan ahead and make food to bring with me (because apparently it’s not super safe to just leave a giant bowl of pasta in your car and assume it’ll be nice and hot by the time you get out of class…).
So that’s today’s installment. Not incredibly informative to anyone who isn’t me, I’ll wager, but it has helped me identify a “next step” I wasn’t thinking about (that is, how to handle lunch).
I just realized I never finished and published my class notes from Wednesday. Derp.
Ummm, yeah. I’m gonna need me to work late tomorrow … and we need to talk about my TPS reports.
To my defense, I got caught up in fall cleaning, opera, and a bunch of other stuff over the past few days. So … um … in short, I’d like to say, “Excuses, etc.,” and leave it at that.
I’m theoretically planning a trip up to Chicago early in November and hoping to catch some classes at the Joffrey … it looks like, due to scheduling, my choices are Intermediate Ballet, Intermediate Ballet, and Intermediate Ballet, so I’m just going to have to hope that Intermediate Class at the Joffrey is comparable to Intermediate Class at Louisville Ballet (which, to be fair, can be pretty challenging, depending on how many company dancers show up on any given day).
Because of an attack of Epic Laziness (aided and abetted by a good, solid, ongoing case of I’m Not Worthy!) this morning, I did not haul my behind out of bed and try Advanced Class.
Given that the Met Live in HD Opera broadcast schedule means I can do either Advanced or Ballet Essentials on opera mornings, I’ve been trying to just bite the bullet and give it a go. I’m probably not really qualified for Advanced class, but I’m not at all certain that I was really qualified for Intermediate class when I first started doing that, either, and we all seem to have survived. Worst thing that could happen is that I go and do barre, completely humiliate myself, bow out before centre, and then weep quietly into my sleeve throughout an entire opera. The best thing that could happen is that (GASP!) I might surprise myself, learn something new, and expand my comfort zone.
That’s a gamble I don’t really mind taking.
As penance (well, okay, really because I was full of caffeine and popcorn), I spent this evening doing traveling chains of cabrioles (which require extensive planning, because my house is tiny, and you kind of have to cabriole around corners a lot) and various kinds of Sissones.
Ballet people, you know you have a really awesome spouse when you can randomly Do All The Sissones in your house’s tiny little hallway and the spouse in question doesn’t even look up and say, “What the heck are you doing in there?”
At this point, though, I think he’s become totally inured to my balletic weirdness (and that thing where sometimes we’re standing around outside a restaurant with friends, and they’re chatting, and I’m thinking about choreography, and randomly start marking out what I’m imagining, kind of thinking out loud with my feet).
So that’s it for now. Autumn is upon us — huzzah!
…And she’s awesome.
Tonight, I read it … and then its sequel … and then the sequel to its sequel.
The tips themselves are great (if, yes, sometimes pretty obvious: but, honestly, even if they’re things you already know, it’s pretty validating to know you’re not the only adult who occasionally calls upon the power of Pigs in Blankets) in a way that will make perfect sense to anyone who thinks a cookbook called Cooking with ADHD is a good idea — but it’s Kacy’s tone of acceptance and cameraderie that really makes it work.
It’s like a friend or a sister or a cousin saying, “Okay, guys and gals, we’re in this together. We kind of suck at this, but we’re doing it anyway, and it’s okay.”
He didn’t become Gandalf the Citrus Moderne Dot, did he?
— Kacy Faulconer
Because, seriously, he didn’t. Because he knew he was going to have to get orc blood off dat shizzle, and you can, as Faulconer points out, bleach white.
My own education as a half-baked homemaker has been very much about giving up on visions of making my own laundry detergent and growing my own vegetables, then embracing my limitations (and strengths) and learning to work with them.
I may not grow my own vegetables, but I turn vegetables that we buy into a mean set of no-sugar-added breakfast muffins every single week, because I not only know how to do that, but like doing it (because I do it well, so it makes me feel good, so I do it more, which makes me even better at it, etc.).
I may not make complex gourmet meals every single day, but just about every evening I do cook a meal that my husband enjoys (fortunately, he is a man of simple tastes, and doesn’t object to a regular rotation of variations on Freezer-Marinated Chicken with occasional forays into Things Made From Ground Beef).
I may use a lot of workarounds, but little by little I’m learning to get stuff done.
That’s the spirit that Faulconer’s blog embraces, and I feel like it’s a spirit whose time has come. So go read her!
Oh, yeah — in other news: did Essentials yesterday morning; was able to crack out the flying chassees and a couple of sautes without my toe falling off or swelling up like a ball of bagel dough. This definitely feels like progress. It also didn’t give me any real trouble today, just the generic “Hey, I’m still healing a little” soreness that has become its temporary new normal (for a while, it was fiercely sore the day after class even if I didn’t do releve work or jumps).
We’ll see how it goes tomorrow.
My mood is hanging in there, somewhere in the neighborhood of the Upper Doldrums. It’s not approaching “good” yet, but it’s at least more tolerable. I am more able to ignore Bad Thoughts (admittedly, by playing Bubble Wars or baking, but still…) when they arrive (but they’re still arriving).
The upside of my current mood? Holy cow, I have never been this productive in the kitchen. I mean, I have reached a point in life at which my kitchen is basically under control (I’ve even started weeding out unnecessary kitchen things and relocating or offloading them). I like being there, I like working there, and our dishwasher died, so now I just wash the dishes by hand and everything stays sorted.
I don’t know. Is it bad to have 24 carrot-pineapple-coconut-raisin muffins hanging around?
On Wednesday, B. and I were chatting during the quick break between barre about how we’d both lost so much ground to injury this year (she with a stress-fractured foot; I with my calf and then my toe). I was like, “Can you believe we were doing brisees last year?”
Anyway, that’s kind of a theme for me, right now. In some ways — mood-wise, ballet-wise — I’m sitting at the bottom of a long climb back to where I want to be.
Fortunately, as a cyclist, the ability and willingness to climb ridiculous hills was and remains one of my strengths, and I feel like maybe I can translate that over to the rest of my life.
That doesn’t mean I’m going to climb this particular set of hills quickly. Just that I know myself well enough to recognize that I’m probably going to make it (even though I’m in that weird place, right now, where you’re rational enough to know that the voice in your head that constantly yammers on like, “You’ve squandered your potential and will never amount to anything now!” is a crazy voice, but not yet in a place where you can make it STFU).
Anyway. So I’m gaining ground more slowly than I would like, but I’m gaining ground.
I guess I can pop in another bike-racing analogy, here: one time, Timothy and I raced Death March while both of us were recovering from various winter illnesses, including some kind of gut thing that was going around. In short, neither of us had been able to eat like a normal person for several days, and we were what a long-ago Arnold Schwartzenegger might have termed “weak little girly-men,” and we did nothing fast, least of all climbing … but climb we did, and (as evidenced by the fact that I am sitting here in my living room, writing this post), we lived to ride another day (in fact, the next year we came back and roundly spanked half the field, although we were in turn roundly spanked by the other half).
Sometimes it sucked, and sometimes we walked our bikes, but at the end of the day, we kept going and eventually made it back to the ranch without having to ride in the Broom Wagon.
So, anyway. I’m not all there yet, but I’m not ready to wait for the broom wagon, either.
As such, here are some plans for upcoming posts, with no particular timeline in mind (though next week would be nice):
- Two Cooking With ADHD posts:
- What To Do With 10 Pounds of Chicken Leg Quarters (Because They’re On Sale)
- How To Make Bread And
- One hopes, a string of Ballet Class Notes, as my foot can definitely handle at least 3 classes per week at this point if I don’t jump too much.
- Maybe a post about writing? I am doing that still.
In other news, I am rocking along in Homemaker Mode and actually rather better at it than I used to be.
This is comforting.
Some of it, of course, is the Miracle of Modern Medicine (go, Adderall!), but some of it is simply a function of the fact that, amazingly, I do appear to be able to learn.
I’m hoping my friend Robert (Hi, Robert!) will be able to come visit before we head out to the desert; maybe when he does I’ll ask him to collaborate on a Cooking With ADHD Video Post, since we have two different flavors of ADHD and we might find different things helpful.
Oh, and I just read Ellen Kushner’s Swordspoint, and I highly recommend it (if Regency-era romping bisexual sword-wieldy people sound like your cup of tea).
That’s it for now.
Maybe if I ever manage to get Cooking with ADHD rolling, I’ll expand it into a guide for the ADDle-pated Homemaker. Goodness knows I could use one!
(That wasn’t actually intended to be a play on the title of the TV series Black-ish, though that seems to be a fairly thoughtful sitcom, as sitcoms go, from the tiny bits I’ve seen of it.)
So I’m back on my meds (huzzah!) as of this afternoon and, as such, improving in terms of overall function … which is good, because the drain in our kitchen sink chose tonight to explode, and I would have had a flat-out meltdown about that if it had happened yesterday. Fortunately, I married McGayver, who can fix that kind of thing.
I’m doing the job applications thing and it’s going well — had an interview this morning for a position that sounds like pretty much a lock (unless I’ve been convicted in absentia for some kind of crime I committed in my sleep?), though it turns out there are no seasonal positions open ’til September. I could have started next weekish as a permanent employee, but it wouldn’t be terribly convenient for the company, as I’d have to run off for two solid weeks for Burning Man.
Unless I find something that’s really relevant to my studies and/or sounds really compelling, I’ll probably take that job in the fall. It sounds like a good fit for what I want right now — an active, rather than a sedentary, workplace; decent pay; hours that mesh nicely with ballet. Shouldn’t hurt the fitness bit, either.
I’ll need to finally get an actual driver’s license, since the job in question may potentially involve actually driving, but that’s in the plans anyway.
I’m still working for Denis’ Burning Man project and feeling ever-more-useful in that regard. Tonight I set us up with a G+ page, even though I still feel kind of iffy about social media as a marketing platform. For this project, though, since it’s primarily a do-gooder collectivist kind of gig, I don’t really mind 🙂
On Glassdoor this morning, I spotted a listing for a web developer with some knowledge of WordPress and Drupal, as well as some command of your general web languages (HTML, PHP, CSS). I’m kind of kicking around the idea of applying for that. The upside is that the pay would very likely be pretty nice; the downside, of course, is that most development jobs are desk jobs, and I’m not really super into that whole idea. Been there, done that, decided it wasn’t for me.
Our finances are on the mend. Since it took about two solid years of complete and utter miscommunication to blow them up, it’ll probably take a few months to get them 100% back on track. Until then, we’ll be wearing our dance belts a little tighter* 😉
My toe is healing. I’m still on the fence about Saturday class. Tomorrow’s out; it’s definitely not ready for Intermediate, and Essentials is cancelled tomorrow. I was able to ride the bike a bit today without driving the toe crazy, but I’d rather let it really heal before I try to push it.
I’ve noticed that Fusion Fitness Dance is back on the calendar, so maybe I’ll give that a whirl at some point, too. That depends on the finances, though. If we’re going to be tight enough that I can only do class two or three times per week for the next while, I don’t want to add a non-technique class.
I guess I’m also going to try not to spring back too quickly from this depression. I tend to decide that “feeling somewhat better = feeling 100% better,” then overtax myself and crash even harder. I hope maybe I’ve learned that lesson by now.
I’ve also learned that, while I now know that there is not, in fact, a famous band called Holland Oats, Harlan Oats, or Haulin’ Oats, I still don’t really know from 80s music. Did you know that “Danger Zone” was a Kenny Loggins song? I sure didn’t until just now. Thanks, Amazon Prime Music.
So that’s it for tonight.
Stay out of the Danger Zone.
You know, unless that’s where you want to be, in which case, carry on.
This title should really come with a long caveat: I’ve taken meds for both ADHD and bipolar in the past, so what I’m talking about here, in part, is why my treatment approach prioritizes the medical management of ADHD over the medical management of bipolar.
I initially meant to just write a post about my treatment protocol; about what I’ve chosen to do (for now) and why. When I started writing, I realized that this is going to have to be a series.
It seems like a good idea to begin with an explanation of what, exactly, I am doing treatment-wise.
I believe deeply in the power of complementary medicine: that is, harnessing both medical (including evidence-based naturopathics) and non-medical treatments.
The difficulty with complementary medicine is that it’s not easy — or, rather, it involves the investment of research and time.
By its nature, a sound complementary approach must be carefully designed to suit the needs and circumstances of any individual patient. Many doctors and patients are hard-pressed to find the time to do that; moreover, not all of us are in positions that allow us to.
It also really helps, as a patient, to have (or to be able to acquire) the background in scientifically-sound research practices that makes it possible to tell a sound study (and, thus, pretty reliable data) from an unsound one.
This, by the way, is one area in which I am eternally impressed with the overall community of mental health patients — perhaps because our conditions are still stigmatized and still, in many cases, under-researched and under-publicized, we tend to be very proactive about doing our homework. Likewise, those of us with solid academic research backgrounds tend to act as advocates and guides for those of us who don’t have as much experience, and I think that’s awesome.
In that same vein, though, complementary medicine tends to require a lot of participation from each individual patient.
It’s not a great solution for someone who just wants or needs to take a pill (or a few pills) and forget about it.
Historically, I’ve been kind of judgmental about that — but the reality is that, for a lot of people, being able to just take a pill (or even a handful of pills) is what is most workable.
Each of us has the right to do what’s most workable, and it isn’t fair for me to make judgments about what makes things workable or not workable for other people (unless they ask me to, and give me information from which to make sound inferences, and so forth!). Ultimately, it’s all about quality of life. If the medication-first approach is less onerous and provides better quality of life, that’s absolutely the right way to go!
What works best for me — that is, what strikes the best balance between usability, disease-management, and quality of life — isn’t going to be the same as what works best for someone else. That’s okay.
That’s one of the cool things about human beings: we’re all different. Sure, sometimes it makes life complicated, but it also makes life interesting.
Likewise, especially where bipolar is concerned, mood-stabilizing meds are an essential first-line therapy for a great, great many people.
Moreover, as with some antipsychotics in the treatment of schizophrenia, mood-stabilizing drugs (a class in which I’m including, for this discussion, both classic mood-stabilizers and also atypical antipsychotics) can prevent some of the brain changes associated with the disease and decrease the long-term likelihood of dementia.
This is something that Denis and I discussed very seriously when we were deciding how to manage things from a medical angle. The research that could determine whether other therapeutic approaches prevent this stuff hasn’t really been done yet. That’s a risk that, for now, I’m going to have to take (to be fair, it’s a reasonable one: there is absolutely no history of dementia in my family, even in the folks who had bipolar or bipolar-like symptoms).
I have had very serious problems with mood-stabilizing drugs in the past, which I’ll outline in my next post — problems which make taking them more debilitating than not taking them.
For me, mood-stabilizing drugs amount to a non-cure that’s worse than the disease, though if it ever gets back to a point at which it’s use them or die, I have given Denis the power to make that call for me (since, by that point, I wouldn’t be in any position to make that kind of decision for myself).
Moreover, they haven’t worked very well for me, and the side-effects (loss of equilibrium, loss of dexterity, tremors, and mental fog, in particular) kept me from doing the things that do work.
Thus, for me, the goal is to avoid mood stabilizers for as long as possible, which means (if I want to keep my brain in one piece) doing a metric crap-ton of research and using every other tool I can lay hands (or toes) on to keep it together … and still accepting that a day may well come on which I will have to go back to taking mood stabilizers anyway.
Each approach comes with benefits and challenges: more medication-focused approaches tend to bring more side-effects into the picture, while a less-medication intensive complementary approach involves a lot of effort, a lot of management, and no small amount of risk. For me, the drawbacks of the more medication-focused approach (debilitating side-effects) outweigh those of the less-medication-intensive approach (a heightened risk level; reduced day-to-day stability).
As an adult in a stable, mostly financially-secure relationship with no children, the risk is something I can afford.
I might feel differently about it if there were kids — especially small children — in the picture.
I grew up with a father whose volatile mood swings were so terrifying to me that, at one point, I opted not to participate in overnight visits for several years. To be fair, his alcoholism greatly exacerbated the problem. After he stopped drinking (and started using mindfulness and other tools to manage his moods), my Dad became someone I enjoyed being around — but little kids, especially, need predictable worlds to live in, worlds in which actions and consequences are linked in ways that make sense as frequently as possible.
I know that, even with my relatively-successful treatment model, there are still moments that the chain of reasonable reactions breaks. I may not be inclined to become abusive towards people or anything, but it’s still scary to be a kid and have no idea why your parent is foaming at the mouth in the general direction of the refrigerator. Likewise, it’s scary to be a kid whose parent goes from cucumber-cool to stark-raving-furious with no apparent transition time. That’s a thing I’m working on, but some of it’s the result of brain chemistry. Mood-stabilizing drugs could combat that tendency.
I might also feel differently about it if I had to be the primary breadwinner: if, tomorrow, Denis developed some kind of illness that prevented him from practicing, I wouldn’t be able to be as selective about the work I do and so forth, which would in turn expose me to many more destabilizing forces and stressors that I currently avoid through lifestyle management. Mood stabilizers might become pretty important in that sort of situation.
So what, you might wonder, does my particular complementary approach look like?
First, I do take fish oil as a mild mood stabilizer, an approach that has seen empirical support in academic research settings. It does seem to help in my case. It’s not perfect, but it’s a good compromise.
Second, I take the generic form of Adderall IR (the immediate-release version), which both helps to manage the executive-function function problems that come with my ADHD and actually, very much to my surprise, helps keep my moods on a much more even keel.
…So much so, in fact, that I’d really like to do some research into the question of whether other people with both rapid-cycling Bipolar I and the “predominantly-hyperactive type” subset of ADHD experience similar effects (I’m also curious about the biochemical differences between those of us with predominantly-hyperactive ADHD and those with the predominantly-attentive flavor).
I really didn’t expect that effect. Adderall is a psychostimulant, and psychostimulants are absolutely capable of precipitating mania in people with bipolar disorder (I have certainly experienced that effect with caffeine). When I started taking it, I was entirely prepared to have to stop for exactly that reason; likewise, my doctor started me out on a pretty low dose to avoid that eventuality.
However, for me, Adderall’s IR formulation behaves in a really interesting way: it both keeps my mood more level (in short, prevents emotional perseveration) during its effective period and makes me freaking tired as all heck when it wears off.
I have a literally lifelong history of insomnia — I slept little as an infant; in preschool, my pediatrician decided that I should be prevented from napping (not that I was sleeping during nap time anyway) in hopes that I would sleep at night; all through childhood and adolescence, I rarely fell asleep before 2 AM; etc. I still find the notion that my 7-year-old nephew just turns off like a light at bedtime absolutely incomprehensible.
The only reliable solution to my insomnia, historically, has been sheer physical exhaustion — which is pretty hard for me to achieve (and was essentially impossible to achieve when I had a desk job). It’s also a diminishing goal post: the more you exercise, the more exercise it takes to achieve exhaustion.
Adderall, bizarrely enough, does the job nicely. It wears off, and I feel tired — often, tired enough to get to sleep at an hour that resembles the hour preferred by the vast majority of my fellow humans. Considering that my brain, left to its own devices, wants to sleep from 2 AM – 10 AM or from 3 AM to 11 AM, that’s no small accomplishment.
Sleep, in turn, is critical to preventing mania for me (this is why any of the extended-release ADHD meds are off the table for me, as far as I’m concerned: fortunately, the generic form of Adderall IR is about the cheapest option going).
For me, sleep deprivation tends to lead very quickly into mania (this is true for most people with bipolar disorder). The less I sleep, the more hyperactive and manic I become, until suddenly I’ve been awake for nine days (yes, seriously, that’s my record) and I think I can conquer the universe, or whatever.
Thus, something that keeps my moods a bit more level during the day and actually allows me to sleep goes a long, long way towards preventing the largest peaks and valleys.
Denis says he does still notice fluctuations in my mood, but their amplitude is significantly smaller. I tend not to notice my upswings (except for the really black ones; dysphoric, agitated mania is very, very hard to miss), so I can’t really speak to that, but I do find that my depressions are less severe and less persistent: my brain just plain doesn’t get “stuck” in low spots as easily.
Likewise, the ability to get more done in the day and just keep my crap together a bit better (the ultimate goal of ADHD meds for most of us who take them) reduces stress, which in turn reduces emotional instability. Stress is huge destabilizing factor for me.
Third, I exercise. A lot.
“A lot,” for me, doesn’t generally mean thirty minutes a day, five days a week. I’m talking about hours every week — a typical Wednesday morning involves a thirty minute bike ride, a ninety minute ballet class, and another sixty-minute bike ride. I also spend much of my time on my feet, doing stuff, when I’m at home. I do all this stuff because I like doing it. I am happiest when I’m moving.
“Exercising a lot” used to mean just riding the bike a lot (like, upwards of two hours a day, in addition to the time I spent running errands and commuting), but I learned a couple of summers back that too much “just riding the bike a lot” can lead to waaaaaay too much sun exposure, which can lead to dizzying manias followed by really, really black depressions.
Now I dance. Getting back into ballet has been immensely helpful. I still get a ton of exercise, but the amount of sun exposure is controllable.
I don’t think ballet by itself would manage my mood, but I think it is, to an extent, the key piece in the whole puzzle — or, if you will, the lubricant in the machine.
Without dancing, the system doesn’t exactly break down right away. For a while, it chugs (and then creaks) along — and then, eventually, it fails.
Fourth, and perhaps most importantly: I am in a position that lets me make choices that in turn allow me to avoid stressors which precipitate episodes of mood destabilization.
This is a privilege. I am absolutely aware of that. It shouldn’t be one, but it is.
I wish every single person living with serious mental illness had the same privilege, because it makes a world of difference for me.
There are entire career paths that I look at and just say, “Nope, that flavor of stress is a huge trigger; not worth it.” Likewise, I’m in a position to consider the relative flexibility of various career paths.
Almost as importantly, I can say no to social invitations when I’m in a spot where the excess stimulation might send me up-spiraling, and I don’t feel obligated to take on social obligations that might get in the way of taking care of myself during difficult periods.
Likewise, it is, ultimately, the real crux of my whole system. It’s the reason that I hesitate to tell anyone else, “You should try what I’m doing!”
I am only able to do this because I’m lucky.
I get that.
Fifth, I pay attention to how things I put in my body affect my mood, and I try to respond accordingly.
Bipolar disorder is a disease of emotional regulation in the brain. The brain has trouble sticking with a nice, stable, basic mood; meanwhile, it all too easily gets stuck in low or high spots. When it’s going up, it doesn’t know how to stop until it hits some critical threshold; then it tends to crash all the way back to the abyssal depths.
The things we eat and drink can help or hinder the brain’s efforts to regulate itself.
Alcohol, for example, is a central nervous system (CNS) depressant. It may make you feel giddy and happy when you’re using it (then again, it may not), but from a biochemical perspective, it’s the opposite of a stimulant.
Under normal conditions, I can have a drink or two without worrying too much about it — but that’s it. Any more upsets the balance of my biochemical apple cart — and it can take days or weeks for my brain to recover its equilibrium; days or weeks in which I experience hellish depression. For me, it’s not worth it.
Caffeine, meanwhile, is a CNS stimulant.
It’s one I seem to have a beastly time processing, as well: an Adderall IR tablet taken between noon and 2 PM will wear off and leave me ready to sleep by 10 or 11 PM; not so much a Diet Coke or a cup of coffee.
Between sleep disruption and stimulant effects, more than a little caffeine quickly begets mania — and it seems that there’s a threshold beyond which there’s no backing down, for me. Up to a point, the conflagration can still be prevented; beyond that point, the flames are going to engulf the entire house before they die back.
Needless to say, I try to manage my intake of both caffeine and alcohol pretty carefully. The alcohol part isn’t hard — Denis and I are barely even social drinkers. Most of the things I do socially (ballet, cycling, creative stuff) don’t usually involve alcohol.
I say “usually” because our longest bike rides often end with a celebratory beer, and some of the more casual ones begin with a celebratory beer — but on rides that begin with a beer, more than one or two isn’t an option anyway. I wouldn’t be able to ride after that.
The caffeine part, historically, has been harder, because caffeine is so ubiquitous.
If you’re out for lunch, for example, and you want a drink that has flavor but not sugar, your options are generally iced tea or diet cola, both of which come with a fairly sizeable caffeine hit. Likewise, for me, the impact of one delicious cup of coffee is disproportionately strong relative to that of one delicious post-ride beer.
When possible, at restaurants, I order plain soda water with a twist of lime or lemon (at home, we drink mostly decaffeinated tea, plain soda water, or just plain water).
There are some foods with which I like plain, still water; beyond that, though, I simply accept that sometimes I’m going to drink some unsweetened iced tea or diet coke, and I try to plan accordingly. (Sugared beverages — including 100% juices, which are still basically liquid sugar — tend to screw with my blood sugar levels, so I avoid them almost all the time. The exception is the rare bottle of Mexican Coke during a lunch break on a long — like 50 miles or longer — bike ride.)
Beyond that, I just eat what I like — so a lot of fresh vegetables, raw spinach, raw cabbage, carrots, quinoa, all the tomatoes, eggs, and so forth, but also smoked white turkey hot dogs (which I prefer to regular ones), chorizo, pizza, and a little ice cream here and there. When I get a rare chocolate craving, I go for it; likewise, when I’m craving salt, I go find something salty — my body wastes salt, so in my case I’m usually craving it because I actually do need it.
For some people, certain foods screw with brain chemistry; beyond the blood-sugar issues that lead me to mostly avoid high-GI foods, I’m fairly lucky in that department. I do count calories, but more often than not it’s to make sure I’m eating enough.
Sixth, my half-baked mindfulness practice.
Like most people with ADHD, I am not a master of meditation. I am pretty good, though, at living in the present moment (this may be the sole benefit of living in Golden Retriever Time: while I’m capable of worrying about the future and obsessing about the past, I can’t while I’m doing anything else, especially anything physical), and the ability to think about my thinking that Adderall has afforded me has allowed me to reflect on what I’m thinking and feeling in ways that I haven’t been able to until now.
That’s a pretty cool development.
Adderall allows me to monitor my moods in ways I haven’t been able to in the past, which lets me check in with Denis about them when I think things are getting out of whack. That, in turn, means we can take action to try to mitigate any manic fires before they get out of control and to use whatever means are necessary to haul me out of a depression before it gets too deep.
Adderall also facilitates both those processes.
Initially, I felt weird about this “Adderall-as-mindfulness-tool” thing: specifically, it kind of felt like cheating. Then I realized that it basically boils down to the fact that, for most people, learning mindfulness is kind of like seeing over a fence that’s just at eye-height; it isn’t automatic, but it can be done with a bit of effort (and a little releve!). Me? I’m standing in a hole. Sometimes I can jump and get a glimpse over the fence, but that’s it. Adderall gets me to ground level. I still have to make the effort once I’m there.
I can’t claim any formal daily meditation practice, but I use mindfulness techniques frequently in daily life, and they help.
Seventh, I try not to be too obsessive about rules.
There are a few that I know don’t offer much leeway: sleep, for example. I really do have to be pretty rigid about sleep.
Beyond that: if I screw up, if things go off the rails … well, that’s part of life. I grew up riding horses, and we accepted falling off sometimes as part of the deal. That didn’t mean that we didn’t work to become the best riders we could, and to hone our abilities to reduce the likelihood of falling off — but it’s a thing that happens.
I build wiggle room into my diet.
I accept that sometimes I’m going to forget to take my Adderall.
I recognize that once in a while I’ll bang my toe coming off the lyra and have to take a few days off from ballet and cycling.
I understand that sometimes I’m going to overdo it being a social butterfly and sometimes I’m going to avoid the entire human race for far too long when I shouldn’t.
I accept that I really actually like diet cola and sometimes I’m going to drink it; I accept that I really actually like beer (hello, Koshihikari Echigo Rice Lager), and sometimes I’m going to drink that, too. I accept that I like the occasional glass of wine with dinner (though not at home; we don’t drink enough to make buying bottles worthwhile).
I accept that my current treatment modality may be only for now; that somewhere down the road, mood-stabilizing drugs may become necessary.
I’m not sure what I’ll do if that happens: like I said before, I don’t take them now because my quality of life with them was worse than it is without. I hope that I could adapt; that I could learn to live with them, but I don’t honestly know.
I accept that, too. It’s uncomfortable, but being upset about it isn’t going to change anything. Sometimes reality is uncomfortable, and while often we can do something about that, sometimes we can’t.
I accept that this current equanimity is a result of the fact that I’m experiencing the longest period of relative (though still bumpy) euthymia I’ve ever experienced, and that I will feel differently at times.
One Last Note
I realize this probably all sounds like a lot of effort. If it was a program that was being prescribed to me, at least, I would think that it did!
In truth, though, this approach mostly takes advantage of my own basic nature; the rest has been implemented a little at a time.
It’s kind of like counting calories: it sounds onerous, but that’s not how I experience it at all. It’s just a habit, a thing that I do. If you’d told me, five years ago, “You’re going to try to note down every single calorie you eat for the next five years,” I would almost certainly have mentally kicked you in the shins. Taken as a whole, that task sounds impossibly huge. Taken in itty-bitty pieces, though, it’s amazingly doable: “Present doughnut, only doughnut.”
Likewise, sometimes I forget, but the fact that I can see that as no big deal and just get back to it when I think of it really helps.
In some ways, the fact that my system of treatment has a number of different parts is a good thing for someone like me. It’s more flexible: when, inevitably, I forget to do one piece on a given day, the rest keeps on going pretty smoothly. I have to either forget one piece for several days in a row or forget several pieces all at once for things to fall apart completely.
Excepting exercise, no one part of this system really requires sustained effort — and exercise is a kind of effort I enjoy. If “sitting behind a desk for 8 continuous hours per day” was part of the system, it probably wouldn’t work as well for me.
Now that I’m pretty familiar with my own individual stress tolerances, stress-related decisions are fairly momentary. My last few semesters in school, I made a lot of decisions based on that premise: can I handle these three classes together? What if I add this one? What if I also do this other thing? The consequences of those decisions may have taken months to unfold, but the decisions themselves were momentary.
If you told me, “YOU CAN NEVER HAVE CAFFEINE AGAIN!” I might actually cry. Well, probably not, but I’d definitely give you a swift mental kick in the shins, and then I’d sulk. Not so much because I love caffeine so much (I can take it or leave it), but because never is a difficult word (and also because you’re not the boss of me, nyah, and you’re not so big :P). On the other hand, on any given day, at any given present moment, choosing not to drink coffee or cola or whatever is no big deal.
I don’t think about not drinking Diet Coke forever; I just think about what I’m drinking right now.
Obviously, that sort of thing is harder where actual physiological addictions are concerned (which is another reason I’m careful with caffeine — I have had to wrestle a serious caffeine addiction a couple of times already; not looking forward to doing that again). For me, in that department, an ounce of Keep That Stuff Away From Me is worth a pound of Betty Ford. It just helps not to think of it as, “I’m not doing this ever.” Because “ever” is a really freaking long time.
Anyway, so that’s the basics. Sorry this is so ridiculously long. I have a lot more thoughts about this topic, and I could keep on writing for hours (growing less and less coherent with each keystroke), but I think this about gets it down.
Next time (whenever that is, because Golden Retriever Time), I’ll write more specifically about my choices with regard to meds.
My experiences with mood-stabilizing drugs have been, in a word, awful. There are a lot of ways in which they interfere with critical parts of my well-being; likewise, there are ways in which they interfere with critical parts of my treatment plan — and they don’t work terribly well for me.
Some thoughts about why things might work for me; maybe also some thoughts about why the things that work for me might not actually work for everyone.
Someday I really will get around to writing about why I’ve taken the particular approach I have to medication (the short version: hypothesis about neurology; side effects; ballet). The long and short of it is that the meds-for-ADHD-first approach seems to work for me so far (caveat: this would not be a good plan for a lot of people with bipolar disorder), though I’m going to have to monitor things more carefully through the sun-drenched months when mania is more likely.
Right now, though, I’m trying to figure out the remaining problem with my Adderall: that I have to remember to take it in the morning, like, before I have taken it. You know. The medication that helps me remember to do things? >.<
I could establish, like, a morning routine; a set of habits that sort of automatically execute every morning — but who wants to do that? Habits are boring and take time to establish. I want instant results without effort*.
I think, instead, I’m going to build a giant Rube Goldberg machine that first drops an Adderall tablet into my mouth, then shoves me out of bed. Because that totally makes more sense than just building boring old habits, right?
Yeah, okay. Maybe I’ll try the whole “habits” thing first.
PS: things are slowly getting sorted in terms of Major Life Stressors. I’m hanging in there through the Power of Ballet.
I don’t think I posted notes the last time I went to class, back before Spring Break and the Week of the Plague (we were both sick last week; fortunately, I was spared the fate of a follow-on bronchitis, unlike Denis). It was lovely, though I was not entirely at my best. There was a new guy, who we’ll call T. It was his third class, and he was doing quite well, so I hope he’ll stick around, and that I’ll see him in class on Friday morning this week.
Last night, we had another new dancer in Margie’s class. Margie asked me to lead her barre, and I subsequently realized I need to remember to keep a hand on the barre when leading a totally new student. In Margie’s class, I often work hands-free, in order to refine balance and stuff. It never occurred to me that a really new dancer might not realize that it’s okay to keep a hand on the barre, but that’s exactly what happened.
My balance was a little off, since I have some lingering fluid-in-the-ears stuff going on, but other than that I did well. Because I hadn’t been in class the prior week, I was also able to see myself with fresh eyes; I realized that my body has changed profoundly in the year I’ve been back in the studio.
My thigh muscles are leaner than I ever expected them to become, which is surprising (my calves are still huge, but no longer “out of spec” with regard to the classical-ballet mold). I’ve regained the flexibility I lost while alternating between sitting at a desk and training for bike races. My arms have learned how to be expressive and graceful.
For me, Margie’s class is now all about refinement and musicality. It’s actually invaluable in that regard.
Once school is out, I plan to keep Margie’s class in the Friday morning slot in my class rotation. Monday and Wednesday mornings, I’ll be doing Intermediate class, and Saturday morning I’ll be doing Beginner class (I’m not quite confident enough to try flailing my way through the Saturday-morning Advanced class yet!).
I will probably skip Wednesday evening class this week because I’m working on my final paper for my Buddhism class — as I said to Denis, I’ve reached “the boring part,” during which I’m basically just putting in all the references I didn’t enter as I wrote the paper because I was writing it on my tablet and tabbing back and forth was a PITA. That falls right into the range of work that is the most challenging for someone with my particular flavor of ADHD, so I’m giving myself time and room to work on it.
Of course, since I know I need to do it and I know it’s boring and I know it’s hard, my brain is also busily suggesting a million other things that I also need, with various levels of urgency, to do. Like, “Hey! It’ll only take a few minutes to complete the updates you need to do for the PorchLight Express Project! Plus, you need to work on that mini-article for Jack Rabbit Speaks! And you still need to take a picture of the trainer you’re offering up for the raffle for CabalAid! If you do those, you’ll feel productive, and that will help you with your paper!”
Well played, ADHD. I see what you’re trying to do, here. (But maybe I’ll do a couple of those things anyway, because I am someone who feeds on the feeling of accomplishment that comes from finishing things.)
In other news, I’m taking a free, 5-week online course offered by Dalhouse University on Canvas Network called “Behind the Scenes: Addressing weight bias and stigma in obesity.”
It looks really cool, and I’m very heartened by the fact that one of the readings for this, our first class week, is a paper from one of my favorite researchers. Dr. Rebecca M. Puhl is a prolific researcher in the field whose work kept popping up as I reviewed the literature upon which I would found my Senior Seminar project; I think I wound up citing four or five papers on which she was either a lead or one of two lead investigators.
Anyway, if you’re interested in the course, it’s not too late to sign up (and you can create a Canvas account for free)! I wish I’d thought to post a link earlier. It really looks like it’s going to be a great class.
Here’s a link, if you’re interested in checking out the course:
Those of you working in the health-care professions may even be able to gain Continuing Education or Professional Development units. A certificate of Completion costs $50 Canadian and provides 15 PD units.
If you don’t have time to take the class but would like to follow along with the participants, we’ll be using hashtag #weighbiasaware on Twitter.
Speaking of Professional Development and Continuing Education, I have some long-term plan updates that I’ll be posting in a bit. Nothing particularly drastic, but I’m feeling pretty optimistic about my road forward now thanks to a chat with Dr. Morgan yesterday morning.
That’s it for now. Keep the leather side down, and don’t forget to ride your bike!