Friday, 24 April 2015

Explaining mental illness: ADHD-predominantly inattentive type/ADD

This is going to be my second post about my personal experience with mental illness and about the taboo on mental illness in general.

As I described earlier, mental illness is taboo. And it desperately, desperately needs to stop being taboo because it wreaks havoc on people and society, and is also a danger to 'healthy' people.
In my previous post I have refrained from using direct examples for this, but there are many to be found, all over the world. I realise that I am probably not going to be applauded for expressing my opinion about this now and using direct examples to illustrate this but I strongly feel like this taboo should be broken and mental illnesses should be treated shamelessly and with the same importance and respect as physical illnesses. I will use more examples as I go along with this series of posts but I will start with (in my opinion) the worst one.

One of the most heartbreaking and painful examples of the results of the mental health taboo is the recent German Wings plane crash. To my understanding, the copilot who was responsible for this terrible event was a long time sufferer of mental health issues but had desperately (and successfully) managed to hide his mental illnesses from both his employer and his friends and family. Refusing to be open about such matters and never talking about them only makes matters worse long term and, as apparently happened with this copilot, can drive you completely insane to the point that apparently, he felt the desperate urge to kill himself and hundreds of innocent people with him. I have not read every article about this but to my recollection no one knew about his mental health problems and after a lot of digging they could only find some evidence from years ago that proved he actually had problems. He managed to hide his true self for so long and apparently felt overlooked and unappreciated for so long that his illness escalated in the most terrible way possible.
Of course, this event is unspokeably heartbreaking and so horrible that I think there no words to describe the pain it had caused. But it is also a very clear cry for help. A cry to end the taboo on mental illness. Because this event is a direct result of the taboo on mental illness. If this man had been allowed or encourages to speak openly about his mental illness without fear or shame for being misunderstood or laughed at or losing his job, then he could have had the accurate care and therapy that he needed and not only would we have a far happier co-pilot but we could also have prevented the hundreds of innocent deaths that he caused by his insane and desperate cry for help.
In memory to this terrible event and out of respect to both this co-pilot and all the others that have died, let this be a lesson to us and reach out to our friends and neighbours, and never be ashamed to talk about your feelings or asking for help. And if someone is asking you for help, be it friend or stranger, reach out to them yourself and treat them with the respect they deserve.

So now, let me start by talking about my own experiences with mental health problems. Today I want to talk about my ADHD-predominantly inattentive type, or the more commonly used term ADD.
ADD is not exactly a mental illness but a neurological illness/disorder. Since people often don't really understand what it is I will try to explain what it is like nonetheless.
ADD can only be treated with cognitive behavioural therapy and medication, and cannot be cured. You simply just have to live with it. Luckily, it also happens to have a perfectly scientific explanation.

In short, ADD/ADHD is a deficiency of certain neurotransmitters (specifically dopamine and noradrenaline) in the frontal lobe of your brain. These neurotransmitters help process all the information that enters your brain through your senses (and thoughts). They basically filter out the unimportant stuff, allowing you to focus on what's important and prevent your brain from getting overstimulated. Because you receive a LOT of information at any given point of the day. You are bombarded by it.
If you are deficient in these neurotransmitters, then.. kaboom! this filtering and processing of information doesn't really work that well anymore. Which basically means that ADD/ADHD sufferers are constantly, day and night, bombarded with information which most of the time is completely irrelevant. This leads to all kinds of problems in daily functioning. In the case of ADHD, it leads, among others, to hyperactivity, due to the constant overstimulation of the brain. I have the non-hyperactive kind which means it is less visible in my behaviour, but it is a constant pain in the ass nonetheless.
Like every deficiency, it can be more or less severe. I have a quite severe deficiency but I am able to more or less lead a normal life, despite the symptoms I experience. The symptoms also vary between people so no one is exactly the same. This is my experience with it.

To me personally ADD displays itself in a whole range of symptoms that greatly vary. I basically think about twenty different things at the same time, which is confusing and tiring and distracting. Due to the overprocessing of my senses I am extremely vulnerable to incentives. Because my brain thinks the random lamp in the corner or the interesting dirt pattern on the wall is equally as important as the essay I should be typing for university, I basically have no focus whatsoever. This leads to a whole range of problems I have to face in daily life. I am unable to clean my house. I am unable to keep a schedule or a weekplanner. I have great difficulty studying and I have great difficulty finishing things. This means I usually have about 10 creative projects running at the same time and am unable to actually finish any of them. When my brain gets fried due to overprocessing, which usually happens at least one time every day, I get heavy moodswings, nausea and sometimes even panic attacks.

The overprocessing of my brain also causes my short term memory to be nearly inexistent because my brain can't keep up with all the information. I constantly forget everything. I can forget what I was talking about mid-sentence, I lose my keys everywhere and when something else catches my attention I am able to just drop anything I am holding at that time and completely forget about it.
Another nasty side effect is that I have a lot of trouble sleeping. Because yep, I am unable to remove the triggers at night or even when I close my eyes, because my eyes get distracted by the wonky blotches at the back of my eyelids, or I suddenly get extremely annoyed with my sleeping position, or I have an itchy spot, or whatever else. When I do sleep my sleep is usually light and I have super weird and vivid dreams out of which I often awake in total confusion while at the same time being super tired.
I am tired all the time. And confused. I honestly cannot remember a moment when I was not tired. Social contact exhausts me, especially in a group, because then I don't only have to respond to my own overprocessing brain but also have to pay attention to other brains. I have days when I am so tired I am unable to get out of the house and it sometimes takes an entire day for me to recover from a weekend of social gatherings. It drains the life out of me sometimes.
There is one thing though that I think is kind of cool, though it can be annoying sometimes.
I have the ability (I call it my super power) to hyperfocus. It comes in randomly and I don't have a lot of control over it but it mostly happens when I am painting. I can paint for 10 hours straight and forget everything around me. I forget to eat, forget to sleep, forget to drink, forget to go to the toilet or forget to run that super important errand I need to do. And then at the end of the day, suddenly the sky is dark, I have to pee and am super hungry, and wondering where my day suddenly went.

Basically, ADD is really really frustrating and distracting. A friend of mine once tried to describe it as having a loud radio turned on that switches channel every ten seconds while ten people around you are constantly throwing ping pong balls at your head, with multicolored flickering lights all around you. That description is probably pretty accurate.

Because of the constant frustration and the inability and/or difficulty to perform normal daily tasks, and because it was never recognised as such and never understood until very recently, I also dare to say that my ADD is the biggest cause of my other mental health problems, such as depression and anxiety, of which I have talked earlier about. In my childhood and puberty, my inability to focus was often dismissed as laziness and unwillingness. My inability to clean my shit up behind my back was also dismissed as lazy, unattentive and rude. After a while, I started to believe those things, which is easy when they're constantly yelled at you. I felt worthless. I felt lazy and guilty for being so, even though I did want to complete household tasks and I did want to finish my homework and be able to study properly for my exams without constantly being distracted. There was just an unexplainable thing that made it a hundred times more difficult for me than for other kids. Since I have always been pretty silent and drawn back when I'm with others (probably in an attempt to minimise the incentives I am bombarded with), there had never been an explanation for it in my youth. I was tested for autism once but it was inconclusive, and that was that. This misunderstanding and the accusations that followed, together with the bullying kids at my primary school (where I had never fitted in), would eventually trigger the first signs of my 13-year long chronic depression, and the misunderstandings built up and up, and eventually escalated enormously up to the point of suicide attempts. But more on that in my next post! Yippee!

So basically, when I suddenly get confused or irritated, or when I lash out at someone a lot angrier than I intended, or when I leave early at parties because I am too tired and overstimulated, remember that I'm not mad at you or not trying to insult you or attack you. It's just.. all this.

One last thing.
I have finally gotten an official diagnosis for my ADD last month, and am currently figuring out the right type of medication. Methylphenidate (Ritalin) does not really have the desired effect (yet). I am going to try out Dexamphetamine (speed) next week. Once I have the type of medication and the dose right I am going to start cognitive behavioural therapy and I can hopefully learn to live with this terribly frustrating and confusing disorder.

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