Disorder

This will shock you: I'm ADD.

It's difficult to say exactly how large a community I belong to; in America, some surveys put the number as high as 6% (roughly eighteen million). Certainly, the popularity of ADD as a diagnosis has sky-rocketed in the last 10 years, bringing it a close second to depression for both Most Diagnosed and Most Over Diagnosed. Over diagnosis has left a stigma on any diagnosis, leaving many ADDers in a state of crippling doubt, particularly when it comes to question of treatment. We're a drug-treatment county focused on silver bullets; the paradigm of treatment does not include healthy, drug free coping strategies. For many the perceived choices are drugs or life as normal.

Few people truly understand what ADD is, so I'll summarize: Attention Deficit Disorder, or ADD, is the common referential for a syndrome more properly called Attention Deficit Hyperactivity Disorder, or AD/HD, which then brakes into three sub-types: predominantly inattentive, predominantly hyperactive, or inattentive/hyperactive. This nomenclature is itself misleading and focused on the perspective of the observer. Commonly misunderstood to be the inability to pay attention, it would more properly be called the inability to ignore; for the ADD mind, every sensory input must be pair attention to, responded to, dealt with. A frequent cohort of this hyper-attentiveness is a mis-calibrated internal energy gauge. If we suppose that a healthy, well rested human sustained by the correct diet will have the energy level five, then his body will begin producing endorphins and hormones to artificially raise his energy level if he forces himself to function at a level of two. A healthy, well rested ADDer could easily have an actual energy level of five, but his body will mis-register it, believing it to be two, and thus will artificially stimulate him up to a perceived level of five and an actual level three above that.

It may seem counter-productive to give a hyperactive child stimulants, but it is surprisingly effective. Small doses of stimulants -- say Ritalin or Aderol -- boost the bodies energy level to five and a half or six, thus crossing the artificial production threshold at two and allowing them to function at an above-average but below-AD/HD-normal energy level. Neither Aderol nor Ritalin are focus aids; all the help comes from simply calming down.

ADD has the distinction of being a vague condition defined by tendencies. ADDers usually seem to not be able to pay attention for long, have trouble sitting still, are probably terrible sugar-fiends, and have poor impulse control. However, unless these behaviors exhibit themselves incredibly powerfully, there's really no way to say if a child is ADD or just bored silly. Maybe they're hyperactive because of ADD, but maybe its a chemical imbalance of a different kind or simply a terrible diet. An ADDer is impulsive, but so is a child whose parents never taught them to stop and think before acting. The result is an internal struggle for those of us who, essentially, recognize enough of ourselves in the description to decide we have to condition. Certainly my experience has been one of long self questioning: am I ADD, or just a failure?

 My mother wanted the best for me and so, when ADD was first brought up,  she put me on Ritalin. To be fair, it helped (a good indicator that the diagnosis was an accurate one). Due to my large size, I was given a very high dose every day until it occurred to me that I didn't have to take it any more. This turned out to coincide well with my junior year of high school (a perfect time for angst-driven traumas). I decided that I'd had enough of being medicated, quit the stuff, and triumphantly nearly flunked out of my private college prep school while my mother watched on, horrified, able to do little but try to convince me to go back on my meds and stop failing.

 I graduated from high school by sheer force of intellect, made it in to college through force of personality, and proceeded to very nearly fail my second semester there. I stayed on and flourished only by dint of two phenomenal teachers, who hauled me in to their respective offices (two meetings a slim half-hour apart), sat me down, and gave me two similar-yet-different versions of a "you need help and we want to give it to you" lecture. Never one for special treatment, I had neglected to mention to either of them my "status" as an ADDer, so I told them then, fully braced for another round of discussions roughly to the tune of "take meds, you need them to not fail."

 "My dear boy, this college employs an ADD tutor. As a student, his services are free to you. I suggest you go see him." My advisor (also my choral director, and later my undergraduate dissertation advisor) said this as though it were the most obvious solution she could see -- which, in fact, it was. I was shocked; like a boy in a bomb shelter who heard no detonation, it was only very timidly that I lowered my guard and admitted that going outside sounded like a very good idea.

It shames me to admit that I can't actually remember my ADD tutor's name; "Richard" is a fine approximation. He espoused a simply philosophy, in my mind most easily likened to architecture. One is bourn with a foundation upon which our teachers, mentors, and experiences help us to build a house. ADD people are simply starting without a level foundation; care must be taken during construction to accommodate for differences that not every builder faces. The dilemma is in the way the world raises ADD kids to be adults; that is, they are raised just like everybody else. We as American's have a hard time with the notion that "different"  does not equate to "bad." Enter drugs, which attempt a sort of retro-leveling of  the foundation. Drugs seek to allow a person whose mind operates in mode B to behave as though it operated in mode A, because mode B is considered inferior or problematic.

Richard, then, made a business of remodeling. By helping kids to learn about themselves he worked to help them develop the coping strategies and habits they needed all along to survive happily in the world they were presented with. A house built on the side of a mountain presents challenges to a builder, but in the end it is no less a house than any other -- it might even be a more interesting house, in the end. One must simply utilize different construction techniques.

(I should mention that Richard managed his eloquent instruction without ever succumbing to building analogies and I regret not being able to simply quote the man to you now.) 

In an elated phone conversation with my father I discovered that Richard made a profession of telling me the same things my father had been telling me for years.  Relax, slow down, and take clear notes; try and structure the beginning and end of each day. Make habits: wake and sleep at the same times, have rituals for each. Leave your house keys always in the same place. Make as many lists as you need too, send yourself as many emails as it takes, record as many voicemails on your own phone as you have to to remember everything you need to get done -- and get in the habit of attending to your own scribblings. Eat a high protein breakfast. Get exercise every morning.

Richard also elaborated on the ADD tendencies. "We tend to be quite intelligent," he told me, "ADD is often a sign of genius.  We're often healers, deeply sympathetic to our friends and able to give a shoulder to any who need it. That said, we usually have a very hard time in groups; we feel like we don't belong, or we get overwhelmed by the number of things happening and either shut down or misbehave. And to make life better, we're often angsty as hell and wildly self-critical, so try and go easy on yourself." To me, this read like a survey of my soul; impressed by his insight, I believed every word he had to said, immediately. I set about trying to take his advice.

It would be foolish for any ADDer to try and structure the entire day, but having a basic set of predictable elements will give enough form that some of the basic unreliability can be smoothed out. The first trick is, of course, to figure out exactly which habits a given person needs to develop -- I went through dozens of different systems before settling on the right method for my life. The second difficulty is in implementation; just because Richard's approach is drug free doesn't mean it's any more a magic bullet than a pill. A classic ADD habit is the strong start with immediate segue to non-participation; after three weeks with my shiny new habits I collapsed into a heap of forgetfulness, sleep at odd hours, and sugar-rich breakfasts.

 Richard was both kind and firm, a non-stop advocate of a "don't give up" mentality I've taken to heart. It sounds cliché, but in this kind of pursuit one must see in every failure a new opportunity for success. I fought my way to my feet and got going again. Soon I had grades to be proud of (relatively speaking) and a sleep schedule that horrified most of my peers. ("What do you mean you're going to bed? It's ten-thirty!")

This has become the way I live my life. Eventually, the habits got easier to maintain, the small failures a little easier to accept and move on from. In no sense do I mean this was easy, but I've learned the value of completing a difficult task at all. I graduated with no honors but my own sense of victory, an ample reward and one I celebrate, quietly to myself, almost a year later to the day. In a culture of uppers at breakfast and downers before bed, I rise and fall with my own rhythm, more regular and stable and some of my "normal" friends. In victory, I find peace.

Comments

[c-diddy]

You did graduate with honors, then. I value your struggle highly.

I didn't know some of the details either about the disorder (hmm, hyperorder) or about you, and I thoroughly enjoyed both.

It's been a terrific relief this year to use extremely detailed to-do lists for everything, home and work, and carry around pens, and put stuff on my calendar. I had been trying to do it by force of intellect for some time, and somehow I thought there was a stigma to using aids. Let Me Tell You! I will never go back.

[Stove]

I suppose the part I didn't mention in the essay is how useful most of these habits are to -anybody-, not just ADD kids. It can be overdone, certainly, but its still good stuff in moderation.