Wednesday, May 31, 2023

A Post for Mental Health Awareness Month

 2 June 2023 Edit - I said I wasn't going to edit this, but I realized I neglected to mention a number of useful tips. I added them to the bottom of the list of tips (Cold Showers, Breath Work, Meditation, Nature & Grounding). I also added links to the songs I listed, to at least make that part more ADHD friendly.



As Mental health awareness month winds down. I once again consider writing and posting a blog about my  own experience with that. I am mortified at the thought of sharing such details. However, over the years, I have read posts, or seen videos which other courageous people have made, which have been of benefit to me, so I find myself weighing my fear of what other's might think of me, against the potential benefit some might derive.

This will be relatively free-form, and I will do very little editing or rearranging, in hopes of capturing the thought process - the way my brain works. So, it may jump a bit, or feel disjointed.


Also, as a warning- the topic of suicide will be addressed. If you are uncomfortable with that, you may want to give this a pass.


First, about me: I am at present diagnosed with ADHD - Inattentive type.

That is a rather stupid name for a diagnosis, and rather problematic for a number of reasons.

AD= Attention Deficit. (Plus Inattentive type; they used to separate ADD and ADHD, now they lump them together and then add "Inattentive", or "Hyperactive" or "Both" as a type. And "Inattentive" is even worse). It suggests I can't pay attention, this is inaccurate. Sometimes I go beyond paying attention to hyper-focus. At other times, I am paying attention to too many things at once. The problem is I can't always control it. 

Many also describe it (accurately, I think) as people with ADHD having fewer "slots" in which to hold things which need focused attention at the same time. So, we have to swap things in and out of working memory more often, and we experience decision fatigue more rapidly.

H= Hyperactive. I'm not hyperactive. Sure, they added the types to distinguish. But the H is still there, in the back of everyone's mind (This is part of why girls with ADHD often go undiagnosed. They don't present with hyperactivity, and they often do well in school, so nobody sees it as ADHD. They therefore often end up with the wrong diagnosis and the wrong treatment).

D= Disorder. With roughly 10% of the population having it, is it fair to call it a disorder? Actually this is starting to shift somewhat. They are beginning to refer to it as a "Socially induced disorder" meaning it is only a disorder because we have created a social and cultural structure in which those with this particular set of characteristics tend not to thrive - a discrimination of sorts. 

Some are now throwing around the term "Neurodiverse". Instead of ADHD. Not sure that is really the right approach either, that is a generic and ultimately meaningless, non-descriptive term.

I have seen some speculation that  the ADHD characteristics were present in the hunters, gatherers, and protectors in early tribes. That seems sensible. Many of the ADHD characteristic would support that role well.

There has also been speculation that ADHD falls  on the autism spectrum. Certainly there are some overlapping characteristics, and the two are frequently comorbid.

It is also noted that Anxiety, Depression, and Addiction are frequent comorbidities with ADHD. I've dealt with all of those.  Technically, I probably don't qualify for an official addiction diagnosis; just a compulsion, as it hasn't disrupted my ability to keep a job, or maintain (within reason), relationships, though it certainly has had an impact on them. 

I suspect that rather than being comorbid, the anxiety and depression were/are secondary "infections" caused by untreated ADHD.


I wasn't diagnosed with ADHD until I was over forty. I was put on my first anti-depressant in high school. It didn't do anything. I've been on nearly every anti-depression and anti-anxiety medication ever made, with varying unpleasant side-effects, and few to no benefits; no lasting benefits at all. 

I actually diagnosed myself with ADHD, and had to convince the doctor of it. Adderall definitely helped me. The generics seem less effective. Lately it has been hard to get either, due to a shortage. I went a couple months without, as nobody had it in my (lower than typical) dosage.

That is tough too; Being treated like a burgeoning criminal all the time. Adderall is heavily abused, so the default assumption is you are potentially an abuser. You can't get a refill prescription for Adderall, you have to request a new prescription every single month (you have to remember to do that every month, which isn't very ADHD friendly...)



I know that the overall effect looks different for everyone, but here are some of the things I have observed in myself, in no particular order:


I love languages and accents. I always try to guess where someone is from when I hear them speak, and when I listen to people with accents speaking, my jaw gets tired from the micromovements in my jaw as I subconsciously mimic them.


At the same time, I barely manage to comprehend English - which is the only language I actually speak. As a teenager, I developed the habit of saying "what?" any time someone asked me something. I didn't actually need them to repeat what they said, I just needed a few extra seconds to process the words they had said in order to comprehend the meaning, and formulate an appropriate response. I am a little better at it now, but only a little.


When I was in first grade, our school class took a tour of the local bank. As the bank manager was showing us all the  different security systems, I was working out how to circumvent those mechanisms. Not because I had designs on robbing a bank, but because it was a puzzle to solve.


When I am in a waiting room, or any room really, I look for patterns in the floor or ceiling tiles (or the curtains or...). And then I look for patterns in the patterns.


In fifth grade someone introduced me to solitaire, I became obsessed with it, but since I couldn't afford a deck of cards, I cut out squares of paper and drew my own deck of cards. My teacher caught me with the cards and yelled at me for having made them. She felt I was wasting my talents. 

Oh that reminds me; once in first grade, during story time, the kid sitting in front of me yelled at me to stop kicking him, and the teacher lifted me up by my hair, shook me and yelled at me. I was engrossed in the story, and completely unaware that my foot was swinging and bumping into him. That was a rather traumatic experience.


When I am working on projects, I will set a tool down to go take care of something else, then come back and spend the next twenty or so minutes trying to find the tool I set down. If you read the Book of Mormon, you might be familiar with Ether Chapter 14, verse 1:

```

1 And now there began to be a great curse upon all the land because of the iniquity of the people, in which, if a man should lay his tool or his sword upon his shelf, or upon the place whither he would keep it, behold, upon the morrow, he could not find it, so great was the curse upon the land.

```

Yep, that's my curse, almost every day.


I have no concept of time. They call it "time-blindness". How long will something take? I have no idea. What day is it? Don't know. I forgot my own birthday one year not too long ago.


Same goes for distance. How long is that stick? How tall is that tree? If I give you an estimate, be warned; it is a guess, and quite likely not at all accurate (Probably within +/- 50%...).


I currently have 60 tabs open on my web browser. Several technical how-to's, a few charts and strategies for keeping your home clean, a few philosophical essays on various economic systems (capitalism, communism... Working on a blog post - a new take on that topic.)


My brain is nearly always running full speed. Nearly anything I get involved in, I will see a few dozen ways it can go wrong. This can be a good thing, in that I am pretty good at risk mitigation. It can also be a bad thing, when anxiety kicks in and shuts me down. Also, while I may see a dozen rather obscure things, I may at the same time overlook something quite obvious.


When faced with a problem I can often see dozens of solutions. Again, good and bad. I can present many alternatives, so if one doesn't work, another is ready to go. On the other hand, I can get shut down by analysis paralysis, going round and round in my head trying to find the best solution, when there rarely is a "best" one.


I often struggle with sensory overload. If someone is talking to me in a crowded room, and someone else is having a conversation within earshot, or if there is music playing or a show on the TV, my brain will usually try to hear both (or all) conversations, and therefore I will comprehend neither. 


When I received my ADHD diagnosis, the doctor gave me a handout, then started to explain something to me. I don't know what, however, because have gave me a handout, and I started looking at it, so my brain did not process the words he was saying (I suppose that was a dead giveaway).


I am often compulsive about finishing things. When I go for a hike on a new trail, it is extremely hard for me to turn around at any point, because I need to see what is around the next corner, or over the next hill. As in, it causes physical pain for me to not.


In College, a friend loaned me a video game once on a Friday afternoon - a game with a well developed story line. I started playing Friday evening. I finished the game Sunday morning. I only took breaks to go to the bathroom. I didn't eat or sleep the entire time. I was so completely hyper-focused on the story, nothing else existed.


I have frequently skipped/missed meals while working on projects (personal or work). I can have a water bottle sitting on my desk, and still go the whole day without taking a drink of water. Self-care is a real and serious issue. I have even tried using alarms, but when the alarm goes off, I will silence it, and finish what I am currently working on first - it will only take a couple minutes (remember that time-blindness?), and I don't want to interrupt my train of thought.


I have a weird relationship with people in general. I like people, I care about people. I want to know how they are doing, and what they are doing, but I am hopeless when it comes to carrying a conversation. My mind goes blank. I don't know what to ask or say.  So, I end up standing awkwardly, until we're both uncomfortable. Also, when I see someone, I will absolutely know who they are, but for the life of me I can't recall their name. It is dreadfully embarrassing.


I am an inherent people pleaser. Perhaps it goes farther than that. I need people to like me, to think highly of me (which is likely the main reason It terrifies me to post this). When I am around a person, my personality, my language and mannerisms tend to shift, mirroring their own somewhat. On the up side, this has made it easy for me to connect with a very diverse range of people, and even be the go-between for groups that have historically not gotten along. On the downside if there is a large diverse group...  Imagine a chameleon standing near a disco ball. It's exhausting. Also, since I subconsciously try to be what people  want me to be, I find I am not entirely sure who I really am.


This also makes therapy difficult. On a subconscious level, I respond to the therapist in the way I believe they want me to respond. And I don't want them to feel bad, so I will superficially improve in order to give them a sense of a successful outcome.


I am terrible at saying 'no', so I often take on more than I can manage, or keep track of. But when I write it all down, the list is so large it overwhelms me. That is a general challenge with big projects. If I don't write down granular enough steps, I will have trouble getting started, but if I see all the steps together, I can become overwhelmed and shut down. But at the same time, I really want to see all of the steps, to visualize the entire process, and see the big picture...


I also tend to take on too much, because I don't like doing nothing, so if I am stuck in a moment where my other projects are paused (or next steps have slipped my mind), I will pick something else up to fill that time. And since I suck at time comprehension, I frequently take on more than will reasonably fit in my schedule (And yes, I have tried a whole slew of calendering and productivity systems to no avail. Bullet Journaling is working better than most...)


Finances are a nightmare for me. I try to create and use budgets, but if an urgency or a great idea strikes me, or someone is in need of a few dollars to help solve a problem... I can't recall the budget, but I am pretty sure there was enough money... (no, there wasn't).


There's this thing called the ADHD tax, and I can attest it is real. I have paid tons in late fees over the years, not because I didn't have the money. I just lost track of the deadline. The worst one however was just a few years ago. Our company was sold to another company in March. The name on the paycheck didn't change however. Come tax time, and the second company sent a W-2 (Salary for Mid-March to end of the year). Somewhere in the back of my mind, I briefly had the thought, "hmm that seems a little low. Oh well, I must have misremembered my salary." The first company never sent a W-2. They expected us to get it from their website. But that didn't occur to me. And if they sent a notice, I either missed it, or it came early enough that I forgot. They did however send it to the IRS, who then hit me with a hefty fine plus interest, for not paying the appropriate amount of tax.


So, yeah, I could probably make a million dollars a year and still look poor on paper.


I despise conflict, even though I often take the contrary voice in conversations, due to my tendency to see all sides of a thing, and a tendency to stick up for the underdog. The world has a great deal of conflict. There are many bullies, and that too often becomes too much for me to bear.


I don't really enjoy sarcasm either, even though I have often used it (that whole chameleon thing, I suspect). The world is full of that as well. And It leaves me feeling sick inside.


I so often feel I am right on the verge of disaster - financial, or social or career most typically. Try as I might, I can't seem too keep it in balance, one or more of the many spinning plates gets dropped. I feel like I am an imposter, living in a world in which I don't belong, living a life I don't deserve. 


It is an interesting observation; I believe in an afterlife. I believe in God. I believe in Jesus Christ, and in the atonement.. I met an old man while I was serving a mission for my church; he was an alcoholic who had been to prison twice for murder. I have absolute confidence the atonement of Jesus Christ will wash his sins away, that he will be made whole and clean one day. Yet somehow, I am unable to believe or accept that it applies to me- That there is a place in God's grand plan... for me. It sounds absurd saying it. I can't begin to wrap my head around why my brain thinks that way, why I am unable to 'fix' that ridiculous incongruency.


Suicide ideation has been a long-term factor in my life. The first time I recall, I was a teenager. The world is hard. And I often feel alone, even when in a crowd. I don't know if that is common to ADHD brain types (or Introverts, which I also am). But I have on many occasions wanted to be done to be free of pain and despair (much of which I acknowledge I manufacture).


I am confident It is not all genetic. I was exposed to pornography ( a particularly violent sort) when I was seven or eight years old, so I really don't recall what it is like to live without addiction/compulsion. The impact of that material on my young, impressionable brain was to build automatic, subconscious, Pavlovian responses to things that most people hardly give a second thought to. I have to constantly be on guard, managing my thoughts. And triggering material is everywhere. I compare it to if you were an alcoholic, and everywhere you went, people were running around with super-soakers filled with bourbon, shooting you in the face. There is rarely a reprieve or escape from it. It is a very real, albeit perhaps nonphysical pain, ever-present. Sometimes, you just want the pain to stop, but it never does.


I was molested at age twelve; at a scout camp. I had a fever of 106 F at the time, and he (a camp leader, not one of my leaders) was taking care of me. It was subtle; I recall feeling uncomfortable, but didn't say anything. It wasn't until ten years later, when I recognized his name in a newspaper article about his arrest for similar behavior that I really connected the dots. I don't know how much this event affected me - I'm inclined to think not much, where it took me that long to even recognize the event for what it was, but who knows; perhaps as some subconscious level that has aggravated my other difficulties. 


My advice to parents - make sure your children understand they should never be alone with another adult (I don't think that was policy back then, or if it was it was not enforced. Requiring adults to follow the "buddy system" serves as strong protection for all involved.) Even it if is an adult you trust, or know to be a good person.


Yes I said a good person. I hold no ill will toward the individual who harmed me, and I do think he was - by and large - a good person with mostly good intentions. I don't know know his past or what demons he's faced. I don't excuse his actions. and I do believe he needs to be held accountable - I hope he got whatever help he needed to resolve his challenges. But before you judge him, consider the degree to which we allow our children's lives to be permeated with media and messages - both overtly and covertly - of a sexual nature, at ages when their brains are not sufficiently developed to cope with or properly process such complex and sophisticated ideas and emotions. If he is a monster, then he is one we created.


So yes, on many occasions in my life, I have had to battle with that particular demon, and I suppose right now would be an ideal time to share how I've done it. I can think of nothing that would be of more use to someone who is struggling right now with thoughts of giving up, and prematurely ending their life.


But I must admit I don't know precisely. 


Partly, I succeed (ironically) through a fear of failure ("With my luck I'll botch the attempt and make my situation worse"). Partly I am fortunate to have a wonderful family (both immediate and extended), and I dread the thought of causing them pain. Partly, I try to practice resilience. I tell myself to hang on for just one more day. Things are bound to get better soon (sometimes It feels like a very empty promise, but... that combined with a tendency to procrastinate... sometimes that's enough to get you through). Much of that you may or may not have at your disposal, or may be beyond your reach to control, but at least you can know - and perhaps take some comfort in knowing - you are not alone.


There are a few things I have found that help:


Routine: A solid morning routine - when I am able to maintain it - is... soothing? comforting? anchoring? Helpful and any rate. I don't recommend creating and trying to follow an elaborate routine from the get-go. Start with one or two things - get up at the same time every morning, drink a glass of water, and brush your teeth. Once you have that down, add more things, slowly, and one at a time, exercise, a healthy breakfast. A similar evening routine is also valuable; even harder to establish - always something to interfere...


Exercise: Physical exercise has tremendous value. Some studies indicate that 20-30 minutes of zone 2 cardio is as effective - or more so - than any anti-depressant. It is a bit tricky to start - hard to find the motivation, but if you can build that into your routine, you will derive considerable benefit.


Morning and evening sunlight: ten to fifteen minutes of exposure to the sun early in the morning, and again in the afternoon has been found to be very beneficial for mood and circadian regulation.


Supplements: There are some supplements which are helpful as well. Fish Oil has been shown in several studies to help with PTSD and Anxiety. Talk to your Doctor to check on possible interactions, and find a reputable source (I've been using Thorne, which I discovered through the Andrew Huberman podcast - he is a good source of science-based information.). I've also found brewed Cacao helpful. It is similar to Coffee in how it is made, but with cacao beans instead. It has much less caffeine, so you don't get the caffeine 'high' and crash effect. It has Theobromine, which is a mild stimulant which works for a longer period. It is a vaso-dilator (vs Coffee is a vaso-constrictor), so improves blood flow, and has several other health benefits.


Music: Music has a number of benefits. For people with ADHD in particular, there are certain types of music which are especially helpful.  The specific structure of certain classical music styles (Mozart, Vivaldi, Bach...) has been shown to help improve Focus. Similar benefits have been found with some electronic music, which uses similar musical structure - complex, intricate rhythms, with repeating, progressive, melodic themes. Positive Lyrics can serve as affirmations - reinforced by the power of music to help embed those thoughts in your mind - which can provide further benefit.


Here are a few I have found particularly beneficial (you should be able to search them on youtube):


Brandenburg Concerto No 3. - J.S. Bach

Symphony #40 in G Minor - Mozart

01 Concerto in D Major FI No. 138 Allegro - Vivaldi

Fly with me - The Fat Rat

Carry You - Ruelle

Climb - Adona

Rise - Caroline Jones

Linked - Jim Yosef

Stand by You - Rachel Platten

In your Eyes - Robin Schulz (feat. Alida)

Walk Thru Fire - Vicetone

Hold on for a Miracle - Svircina

I am the Storm - Ad Infinitum (This is rather aggressive - Swedish Death Metal - so may have limited appeal. I have found the message to be very uplifting however. And variety has its own benefit.)


Speaking of affirmations: those are also good to have. Personal values and goals as well. Write them down, keep them where you can see them frequently throughout the day. Having your purpose firmly fixed in your mind can carry you through many difficulties.

Cold Showers: I saw a video (which I can't find now) a few years ago, listing a number of benefits for cold showers (Boost Dopamine production, improves skin health, lowers your power/gas bill...). This narrative video by Jonna Jinton is really the one which pushed me to try it. It is really quite helpful. You shouldn't do the Ice bath without supervision; people have passed out and drowned doing that. But the cold shower is generally available to anyone. Go as cold as you can possibly stand it. 25 C (77 F) is considered room temp, and it feels quite cold, and even that has benefit. 20 C (68 F) is considerably more effective. I think beyond the biological benefits, there is also a psychological benefit to doing this in the morning. Doing something hard first thing gives you a confidence boost, sets you up for success. I wouldn't recommend doing it daily; maybe two or three times a week. That will help maintain a novelty factor for your brain, and prevent it from adapting and compensating.

Breath Work: There are breathing exercises which are also very beneficial, This Wim Hof Technique is particularly helpful. The "Whisky, Water and Coffee" techniques are also useful.

Meditation: It can be difficult to find the time for this, but a good meditation practice can be very helpful. It can help develop better control over your brain- the thoughts that ramble around in there. There are several types of mediation techniques which work; Mindfulness meditation (also referred to as sensory awareness meditation), Yoga Nidra, Labyrinth Walking.

Nature & Grounding: There really is something to connecting with the natural world, which is very emotionally healing, grounding. Just going for a walk in the woods can make a huge difference. If you can, spend five or ten minutes barefoot on the grass or dirt. This one sounds a bit silly perhaps, but there are legitimate studies showing real benefits.


A few recommendations for those who wish to help those who are struggling:


Don't try and guilt them (i.e. "Think of the people you will hurt if you take your life..."). Believe me, they are doing plenty of guilting already. The last thing they need is for you to pile on more. If they open up to you about suicidal thoughts, Thank them for trusting you, and for being courageous enough to speak to you about such a difficult topic. Encourage them to seek out professional help, or other trained resources.

Don't become invested. Remember the saying about the oxygen masks in airplanes (Put your own mask on first) - you can't help them if you can't breath yourself. Invite them to come to the light with you, don't chase after them in the darkness.

Don't push pharmaceuticals as the fix. Yes, they have their place, but they aren't a magical cure for most. One of the big problems people in these circumstances face is there is a misconception that they just need to find the right drug and poof, everything will be all better and they will live happily ever after. The pills often don't work, or work for a period before the body adjusts to them and nullifies their positive effects. They often come with side effects, which outweigh the benefits. A Therapist or a good life coach would probably be of far greater benefit, and certainly SHOULD be a component of the whole treatment plan. Unfortunately, it is hard to find one who is "the right fit". Also insurance rarely covers that cost.

Don't tell them to "just choose to be happy" or "change their mindset", a blind person can't "just see", a quadriplegic can't "just walk", whether a learned behavior, or an actual physical defect in the functioning of their brain, they can't just flip a switch and be better. In some cases, they might never be "better" in this life. Learning to cope, and finding the tools to allow them to function might need to be the goal. Baby steps.  Encourage them, push them (kindly), but recognize it is a process, and there may be hard limits which will need to be worked around rather than eliminated or ignored.

Don't absolve them of responsibility, or cater to their misconceptions or misperceptions. It isn't helpful to support their illusions, or to allow them to pursue escapism. Reality  is reality, and they need to face that, even if it is difficult. You can do this kindly, of course. You can even offer to help clean up the mess, but they must first accept that there is a mess, and that it needs to be cleaned up.

Just as someone who was born without a limb has a lifelong struggle, so often do those with mental  health challenges. For physical challenges, we often make efforts to adjust our world to compensate for their "deficiency" - wheelchairs, handicapped parking spaces, ramps, automatic doors... Why not give thought to the things in our environment which impede their progress, or make things harder for them? I don't know precisely what that might look like, and I don't suggest looking to government to legislate a solution (they will most certainly get it wrong). But perhaps, as a community, we can be more thoughtful, kinder...


This post is not very ADHD friendly, so I'm not off to a great start on that last bit - sorry. TO be fair ADHD is not the only challenge I have addressed, though it is perhaps a key component or contributor of much of the rest. But hopefully, if you managed to get through this, you have been able to derive some value, or find some hope.


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