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Living with less effort—with
ADD Treatment
 Three
months before becoming seventy years of age I was diagnosed with
ADD.
Unlike so many, I could not have learned about this through children
and grandchildren, for I have none. A friend of mine, a pharmacist,
learned of her own ADD some ten years ago, and has benefited greatly
from medication.
We used to talk about our lives, and she’d tell me about
ADD, and about medication; but the differences in our stories were
more obvious to me than the similarities. Only very slowly did I
begin to make out the pieces that did resemble each other, and which
were the ones that signaled ADD. What follows are some highlights
of my own story.
As a child I felt “different;” socially very far behind
my classmates; my mother called me a “wallflower” because
I had no friends. I was the eldest of four children in a family
with alcoholism. My mother’s work was at home, and her strategy
for household and family management was to impose tight structure
on everything. For example, we had meals served at exactly noon
and five p.m., without fail. Mother often said she felt like she
was “under the gun” to have meals on time. She worked
very hard and was generally overwhelmed. I suspect now that rigid
structure was how she survived.
I attended the same school from kindergarten through high school.
The school was connected to a teacher’s college so our teachers
were well qualified, and we had bright, creative student teachers.
Our classes numbered about twenty students, so there was enough
teacher attention for all. I was a quick learner and quick to raise
my hand with the answers, which did not endear me to my classmates.
After a semester of college I began nursing education, doing well
academically but not socially. As I began my last year, I entered
the Religious Order that taught in the school, in due time enrolled
in a baccalaureate nursing program, testing well enough to bypass
some classes. On graduation I easily obtained jobs as head nurse,
supervisor and director of nursing, but always needed lots of reassurance
that I was doing all right.
At forty I started a graduate program in Advanced Psychiatric
nursing. For years I had declined suggestions that I go to graduate
school, saying, “I already know more than I can do anything
about and if I learn more I will be more frustrated.” I suffered
with having more innovative ideas than I could bring to fruition.
When I did finally attend graduate school I did well enough to be
inducted into the National Nurses Honor Society, even though I was
competing with students fresh out of college, who didn’t have
to unlearn first, as I did, before they learned what was current.
Others saw my accomplishments, but I knew how I struggled internally,
and saw myself as never quite measuring up. I fully expected my
diploma at graduation to be blank. I did almost miss my first graduate
class because I got lost; I have always had a problem with directions.
If I were given the directions to some place I also needed directions
to return. I have been lost all over the country, but never permanently.
I always turned up somewhere.
I began getting some therapy during graduate school, working primarily
on my ”high expectations.” After graduate school I worked
as a Clinical Nurse Specialist for about ten years, enjoying innovative
and creative projects most. But I continued to feel there was something
not right with me, and I asked for some testing. I would be, most
days, mentally exhausted from the sheer effort it took to concentrate
on what I was doing and maintain interest. I agonized over presentations
and projects, finding it hard to categorize and prioritize. In response
to my request, I was given several psychological tests and told
there was nothing wrong. This was bad news, because “nothing
wrong” could not be treated.
For “professional reasons” I went to a workshop for
Adult Children of Alcoholics, and learned that many of my own problems,
still plaguing me in spite of my accomplishments, could be attributed
to having grown up in a family with the disease of alcoholism. The
only responsible or hopeful thing to do was to take care of this
area of damage, too, so I began treatment for Co-Dependency. I did
all I could to make a healthy recovery, hoping to live more comfortably.
Conversely, I upset my own applecart considerably when, at age
52, I left the Religious Order to which I had belonged for 32 years.
Changes in the church and in health care had been very difficult
for me. I no longer felt a personal sense of belonging, and we were
unable, in my professional judgment, to guarantee the excellent
and highly personalized care we had previously been able to deliver.
I now believe another impetus for leaving the Order was an inner
restlessness, which registered as an awareness that I could not
continue to grow while dependent on the security and structure,
which had sustained me for so long; they now confined me.
I married right away. I chose well in a husband who could provide
anchoring and support for me; I opened a private practice and facilitated
Co-Dependence Recovery Groups. The work was rewarding, creative
and fulfilling; my story was published in a book entitled “How
I Became a Nurse Entrepreneur.” I was happier than I had ever
been.
Still, I felt driven, always thinking I should be doing something
other than what I was doing. I felt guilty about how many projects
I had conceived and not finished. My filing system was a disaster
-- I had no idea how to put things with like things. Even though
my office and home looked neat and orderly, I could rarely
find anything easily. I joked that my retrieval system was different
than my filing system.
My husband was diagnosed with End Stage Renal Disease approximately
six years after we married. This was a very difficult time for both
of us. We faced crisis after crisis: he was on dialysis, had a kidney
transplant with countless complications, and soldiered on heroically
as each new challenge hit. We were both committed to growing as
individuals and as a couple, and actively continued to do both until
his death only eleven years after we married.
Then I lived alone, for the first time in my life. My experience
of “inner chaos” increased. I can now see that I had
been supported and protected by a great deal of external structure
at each phase of my life. My early years of Nursing Education were
very structured and the early years in religious life were totally
structured. I remember saying often (without knowing why) that I
entered the convent partly because I knew I needed the structure!
I had learned many ways to compensate for whatever was lacking within
me -- but had no idea why I had to -- and life always seemed harder
to me than it reasonably ought to be.
I felt stuck, like I had gone as far as I could. I was now totally
on my own.
As I gained insight, finally, into what might lie at the bottom
of what had troubled me over the decades of my life, I asked my
friend to recommend books about ADD. I read all she suggested and
more. I could see myself clearly in much of what I read, and finally
“admitted” I fit the picture, but was able still to
turn a little knowledge against myself for a time; since the books
all said not to diagnose oneself and I was not ready to ask someone
else’s opinion, I held out a while longer, figuring erroneously
(after all those years!) I could handle it with out help.
In a characteristic loss of proper focus, I’d remind myself
that I had survived for 69 years, and that to others my home
and life looked organized and neat. Then I’d recall,
again, how much effort it took and how disorganized and overwhelmed
I felt.
I had long told myself that when I had time I would “get
organized.” Now I was retired. I devoted a year to this, serendipitously
discovering a book called, “The Gift of a Year” by Mira
Kirschenbaum, which advised, “Knowing what you really need,
taking your need seriously, and devoting a chunk of time to it …
Prioritization is the key. Focus is essential.”
Oh, the irony! I found organizational systems I had set up at
an earlier time, but never followed through. I found countless projects
begun and not completed. My computer files were incredibly complicated
(folders within folders) and I unearthed unfinished business I had
forgotten.
I knew what to do. Sometimes I had started to do it – the
trails are everywhere -- organizing projects, tools, gadgets, clippings,
books, references and articles. I just never seemed able to follow
through with one system. I lost interest, moved on to the next one;
sometimes I started what I thought was a new one, only to find I
had done so before and abandoned it.
Even when I saw in this debris the severity of my symptoms, I was
still reluctant to seek a diagnosis, partly because I was adamantly
against using medication. I had refused antidepressants during the
five years of my husband’s illness while involved with Well
Spouses Foundation. Seven wives of men with kidney disease, deeply
connected through mutual sharing and support, all of us under enormous
stress; and all but one taking prescribed antidepressant medication.
I held the view that I “could do it without medication,”
as though to do so, and suffer unnecessarily, was a kind of badge
of honor. I now regret that rigidity.
After my year of “trying to get organized,” I concluded
I must obtain a consultation. I was exhausted from trying to accomplish
more than I had or could. Maybe life did not have to be quite so
hard. I got up the nerve to call for an appointment and had to wait
over six weeks to get on the schedule; the doctor’s office
rescheduled three times after that. I wanted to believe that was
a sign I was not supposed to do it, but I had promised myself I
would and I kept my promise.
With a relatively brief interview the psychiatrist tentatively
agreed I had ADD. I began stimulant medication. The very next day,
while driving on a freeway, I realized it was different. For the
first time I didn’t feel overwhelmed by the subjective experience
of driving: the signs no longer seemed to be coming at me.
I could see them with a whole new perspective. Now I could use my
side mirrors, having never done so – what I saw in them was
confusing -- and I thought it would force me to turn my head. I
cannot put words to all of it but it was a totally new experience,
and symbolic of the many new views of common daily activities which
had boggled and tired me out for decades.
At first, I let the medications do the work, and sometimes got
careless about some of the organizing compensations I had developed.
I learned that was a mistake. I still needed them. I am even learning
more compensatory strategies because I have better ability to use
them. I am not sure that I am on the optimum medication schedule
yet – but each trial has been better than the last adjustment.
Discovering an explanation for my ongoing struggle, learning that
I am not alone and that there is help, gave me reasonable hope.
It was the beginning of a whole new way of life for me; it is the
life I’ve been attempting for years, in which the ongoing
challenge of growth remains a priority.
This includes active participation in doing what I need to do
to live as well as possible with ADD. There are many challenges
and there always will be; but there is nothing new in that. Within
the reality of what is I am living with less effort all the
time. Life is not as hard for me as it used to be.
Next: Mentorship Program at
NCGI >> |
